Provider Demographics
NPI:1770802357
Name:ALONZO, CATHERINE MICHELS (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MICHELS
Last Name:ALONZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:LEA
Other - Last Name:MICHELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16 FOX RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2219
Mailing Address - Country:US
Mailing Address - Phone:718-570-5063
Mailing Address - Fax:
Practice Address - Street 1:49 LAKE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4501
Practice Address - Country:US
Practice Address - Phone:203-869-1285
Practice Address - Fax:203-737-8035
Is Sole Proprietor?:No
Enumeration Date:2010-05-22
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241260208800000X
CT49084208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology