=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043926256
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA CATALDI BS, LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2023
-----------------------------------------------------
Last Update Date | 01/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 145 ROCKLEDGE AVE
-----------------------------------------------------
City | ROCKLEDGE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19046-4292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-722-2923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 227 GRAVEL HILL RD
-----------------------------------------------------
City | HUNTINGDON VALLEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19006-1313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-771-6197
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MSG003180
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------