Provider Demographics
NPI:1700084761
Name:BARILLO, CATHERINE DOMINGO (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DOMINGO
Last Name:BARILLO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 BULLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1814
Mailing Address - Country:US
Mailing Address - Phone:845-361-3096
Mailing Address - Fax:
Practice Address - Street 1:363 BULLVILLE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1814
Practice Address - Country:US
Practice Address - Phone:845-361-3096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025253-1225100000X
FL18241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist