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General NPI Number Information
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NPI Number | 1548461403
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Entity Type | Organization
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Legal Business Name | CATANA PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 TALLWOOD DR
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City | SHIRLEY
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State | NY
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Zip | 11967-2256
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Country | US
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Telephone | 631-745-3515
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Fax | 631-395-7889
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Provider Business Mailing Address
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Address Line | 24 TALLWOOD DR
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City | SHIRLEY
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State | NY
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Zip | 11967-2256
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Country | US
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Telephone | 631-745-3515
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Fax | 631-395-7889
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CHARLES GENNARO
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Credential | PHYSICAL THERAPIST
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Telephone | 631-745-3515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 024052
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License Number State | NY
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