Basic Information
Provider Information
NPI: 1851506752
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CATLIN
FirstName: LAURA
MiddleName: L
NamePrefix: MS.
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 78 ARGILLA RD
Address2:  
City: IPSWICH
State: MA
PostalCode: 019382653
CountryCode: US
TelephoneNumber: 6179473925
FaxNumber:  
Practice Location
Address1: 103 JOHNSON ST
Address2:  
City: LYNN
State: MA
PostalCode: 019024001
CountryCode: US
TelephoneNumber: 7815932727
FaxNumber: 7815932542
Other Information
ProviderEnumerationDate: 05/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X11454MAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home