Healthcare Provider Details

I. General information

NPI: 1609508290
Provider Name (Legal Business Name): ELIZABETH MARIA CATALANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 KELLUM ST
LINDENHURST NY
11757-1508
US

IV. Provider business mailing address

12 SYBIL PL
SMITHTOWN NY
11787-1515
US

V. Phone/Fax

Practice location:
  • Phone: 631-884-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number011043
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: