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Individual

CATHY RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
100 GRANNY RD, FARMINGVILLE, NY 11738-2879
(631) 994-1075
(631) 350-0293
Mailing address
1600 CALEBS PATH EXT STE 122, HAUPPAUGE, NY 11788-5224

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
554743-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403021
NY

Other

Enumeration date
07/29/2008
Last updated
12/11/2025
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