Provider Demographics
NPI:1447658588
Name:PANADERO, CATHERINE E (DPT, PT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:E
Last Name:PANADERO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:E
Other - Last Name:PATZNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:1 CREDIT UNION WAY FL 3
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:
Practice Address - Street 1:111 WILLARD ST STE 2A
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1274
Practice Address - Country:US
Practice Address - Phone:617-471-4491
Practice Address - Fax:617-471-1114
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist