Doctor Name: | MS. GRETA CATHERINE VANDEWATER |
NPI Number: | 1013199785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 559430-1 |
Business Practice Address: | 40 Entrance Way Mahopac, NY - 105411302 |
Business Phone Number: | 8455196032 |
Business Fax Number: | |
Mailing Address: | 40 Entrance Way, MAHOPAC |
State: | NY |
Postal Code: | 105411302 |
Phone Number: | 8455196032 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2007 |
NPI Last Update Date: | 12/04/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0200X |
License Number: | 559430-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |