Basic Information
Provider Information
NPI: 1881782944
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOBSON
FirstName: CATHERINE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: PT, MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1014
Address2:  
City: CLARK
State: NJ
PostalCode: 070661014
CountryCode: US
TelephoneNumber: 7328559751
FaxNumber: 7328559755
Practice Location
Address1: 291 FRANKLIN AVE
Address2:  
City: WYCKOFF
State: NJ
PostalCode: 074812849
CountryCode: US
TelephoneNumber: 2018471457
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/11/2006
LastUpdateDate: 03/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00499100NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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