Provider Demographics
NPI:1649539586
Name:PRINCE, CATHERINE THERESA (DO)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:THERESA
Last Name:PRINCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:LANKENAU MEDICAL CENTER - DEPT OF INTERNAL MEDICINE
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:484-476-3305
Mailing Address - Fax:484-476-8141
Practice Address - Street 1:198 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2202
Practice Address - Country:US
Practice Address - Phone:530-342-0123
Practice Address - Fax:530-342-6475
Is Sole Proprietor?:No
Enumeration Date:2012-05-13
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014555207R00000X
CA20A17322207RC0000X
PAOS017299207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine