Provider Demographics
NPI:1881116960
Name:POPOW, CATHERINE I
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:POPOW
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2656
Mailing Address - Country:US
Mailing Address - Phone:732-609-2871
Mailing Address - Fax:
Practice Address - Street 1:242 OLD NEW BRUNSWICK RD STE 140
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3999
Practice Address - Country:US
Practice Address - Phone:732-505-7336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-24-74694103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst