Individual
CATHERINE MAE LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPN
Contact information
Practice address
106 S PERRY ST, WATKINS GLEN, NY 14891-1615
(607) 535-8282
(607) 535-8284
Mailing address
106 S PERRY ST, WATKINS GLEN, NY 14891-1615
(607) 535-8282
(607) 535-8284
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
717530
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
717530
—
NY
Enumeration date
10/04/2018
Last updated
10/04/2018
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