Provider Demographics
NPI:1780060947
Name:VOGEL, CATHERINE ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ROSE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 OGDEN AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-1207
Mailing Address - Country:US
Mailing Address - Phone:202-460-6036
Mailing Address - Fax:
Practice Address - Street 1:25 ROCKWOOD PL
Practice Address - Street 2:ACTIVE JOINT ORTHOPEDICS
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4957
Practice Address - Country:US
Practice Address - Phone:201-503-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1126193OtherNCCPA ID NUMBER