MEDICARE: EDGAR CATALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	027528	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053369819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGAR CATALA MD

Provider Business Mailing Address
First Line	:	133 SCOVILL ST 101
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06706-1127
Country	:	US
Telephone Number	:	203-709-5680
Fax Number	:	203-709-5688

Provider Business Practice Location Address
First Line	:	80 PHOENIX AVE
Second Line	:	SUITE 303
City	:	WATERBURY
State	:	CT
Zip	:	06702-1418
Country	:	US
Telephone Number	:	203-756-8459
Fax Number	:	203-591-8311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	12/23/2015

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