Provider Demographics
NPI:1841899499
Name:NOBILE, CATHERINE ANN (PSYD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:NOBILE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MAINE AVE APT C2
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3638
Mailing Address - Country:US
Mailing Address - Phone:516-527-0310
Mailing Address - Fax:
Practice Address - Street 1:72 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3526
Practice Address - Country:US
Practice Address - Phone:311-863-1417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023823103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist