Healthcare Provider Details

I. General information

NPI: 1477236362
Provider Name (Legal Business Name): PAUL JOSEPH CATASCA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 CENTRAL AVE SE
ALBUQUERQUE NM
87123-2732
US

IV. Provider business mailing address

1124 PARSIFAL ST NE
ALBUQUERQUE NM
87112-5241
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-0917
  • Fax:
Mailing address:
  • Phone: 505-480-6958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00005104
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00005104
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: