MEDICARE: ALEXANDRIA NICOLE CATALANO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	07608	NJ
2	122300000X	Dentist	064865	NY
3	122300000X	Dentist	22DI03113200	NJ
4	1223P0221X	Pediatric Dentistry	064865	NY

General Provider Information

NPI Number	:	1144926288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA NICOLE CATALANO DMD

Provider Business Mailing Address
First Line	:	3010 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2015
Country	:	US
Telephone Number	:	718-285-8570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	02/10/2026

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