=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659286607
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. NICOLAS CATRAMBONE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2026
-----------------------------------------------------
Last Update Date | 08/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2047 E WILLIAM ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19134-4037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-201-7351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2047 E WILLIAM ST
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19134-4037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-201-7351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133VN1201X
-----------------------------------------------------
Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
-----------------------------------------------------
License Number | 86289582
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------