Basic Information
Provider Information
NPI: 1760698872
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERZOLLA
FirstName: CATHERINE
MiddleName: ELLEN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 WESTCHESTER AVE
Address2:  
City: PURCHASE
State: NY
PostalCode: 105772547
CountryCode: US
TelephoneNumber: 9146075730
FaxNumber: 9144571195
Practice Location
Address1: 644 W PUTNAM AVE
Address2:  
City: GREENWICH
State: CT
PostalCode: 068306088
CountryCode: US
TelephoneNumber: 2032102880
FaxNumber: 2032102881
Other Information
ProviderEnumerationDate: 05/15/2007
LastUpdateDate: 11/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X256580NYN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X049818CTY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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