Healthcare Provider Details

I. General information

NPI: 1023094711
Provider Name (Legal Business Name): RAYMOND CATANIA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

786 MOUNTAIN BLVD
WATCHUNG NJ
07069-6268
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 908-754-0975
  • Fax: 908-754-0260
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MB07273300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: