Healthcare Provider Details

I. General information

NPI: 1023182615
Provider Name (Legal Business Name): CATHY L METTA RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 WILLOW AVE
HOWELL NJ
07731-2507
US

IV. Provider business mailing address

8 WILLOW AVE
HOWELL NJ
07731-2507
US

V. Phone/Fax

Practice location:
  • Phone: 732-942-8648
  • Fax:
Mailing address:
  • Phone: 732-942-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NO05915400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: