Organization
CATHERINE POULOS PSYCHIATRIC NURSE PRACTITIONER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHERINE POULOS NPP (NURSE PRACTITIONER)
(631) 495-3300
Entity
Organization
Contact information
Practice address
349 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5051
(631) 495-3300
(631) 822-2833
Mailing address
349 MEETING HOUSE LN, SOUTHAMPTON, NY 11968-5051
(631) 495-3300
(631) 822-2833
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401489-1
NY
Other
Enumeration date
06/16/2013
Last updated
06/16/2013
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