Provider Demographics
NPI:1508140419
Name:SCIMONE, CATHERINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:SCIMONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3996 BEL HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2619
Mailing Address - Country:US
Mailing Address - Phone:315-622-9326
Mailing Address - Fax:
Practice Address - Street 1:350 WOODSPATH RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2840
Practice Address - Country:US
Practice Address - Phone:315-453-1252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342149-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse