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General NPI Number Information
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NPI Number | 1629626049
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Entity Type | Individual
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Provider Name | GRACE CATALA MS, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 220 HOFSTRA UNIVERSITY # 101
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City | HEMPSTEAD
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State | NY
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Zip | 11549-2200
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Country | US
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Telephone | 516-463-5883
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Fax |
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Provider Business Mailing Address
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Address Line | 1808 CORPORAL KENNEDY ST
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City | BAYSIDE
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State | NY
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Zip | 11360-1447
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Country | US
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Telephone | 646-522-4135
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001717
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License Number State | NY
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