Healthcare Provider Details

I. General information

NPI: 1699769596
Provider Name (Legal Business Name): CINDY B CATANIA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W231N1440 CORPORATE CT
WAUKESHA WI
53186-1303
US

IV. Provider business mailing address

3301 W FOREST HOME AVE
MILWAUKEE WI
53215-2843
US

V. Phone/Fax

Practice location:
  • Phone: 262-896-6000
  • Fax:
Mailing address:
  • Phone: 414-389-2377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42170
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number42170
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: