Provider Demographics
NPI:1053007542
Name:NUBIDOC
Entity type:Organization
Organization Name:NUBIDOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-680-2028
Mailing Address - Street 1:1100 JEFFERSON RD STE 12
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-3200
Mailing Address - Country:US
Mailing Address - Phone:585-496-9040
Mailing Address - Fax:
Practice Address - Street 1:923 JACKSON ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4926
Practice Address - Country:US
Practice Address - Phone:585-496-9040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care