Provider Demographics
NPI:1679544969
Name:CATOR, POLLY A (MD)
Entity type:Individual
Prefix:DR
First Name:POLLY
Middle Name:A
Last Name:CATOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 TAUGHANNOCK BLVD
Mailing Address - Street 2:PO BOX 366
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3328
Mailing Address - Country:US
Mailing Address - Phone:607-277-4035
Mailing Address - Fax:607-277-3888
Practice Address - Street 1:149 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2926
Practice Address - Country:US
Practice Address - Phone:607-753-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183770207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01510705Medicaid
NYDD3722Medicare PIN