# CATHERINE POULOS PSYCHIATRIC NURSE PRACTITIONER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457790198
- **Authorized official:** MS. CATHERINE POULOS NPP (NURSE PRACTITIONER)
- **Authorized official phone:** (631) 495-3300

## Contact information

- **Practice address:** 349 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5051
- **Practice address phone:** (631) 495-3300
- **Practice address fax:** (631) 822-2833
- **Mailing address:** 349 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5051
- **Mailing address phone:** (631) 495-3300
- **Mailing address fax:** (631) 822-2833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | F401489-1 | NY | Yes |

## Other

- **Enumeration date:** 06/16/2013
- **Last updated:** 06/16/2013