Healthcare Provider Details

I. General information

NPI: 1811868680
Provider Name (Legal Business Name): CATHERINE ELIZABETH VULCANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DARIA LN
BERKELEY HTS NJ
07922-1268
US

IV. Provider business mailing address

6 DARIA LN
BERKELEY HTS NJ
07922-1268
US

V. Phone/Fax

Practice location:
  • Phone: 908-405-4623
  • Fax:
Mailing address:
  • Phone: 908-405-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR10733600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: