MEDICARE: KRISTA A CATALAN PT

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	225100000X	Physical Therapist	007877	CT

General Provider Information

NPI Number	:	1407888332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA A CATALAN PT

Provider Business Mailing Address
First Line	:	435 HARTFORD TPKE
Second Line	:	SUITE U
City	:	VERNON
State	:	CT
Zip	:	06066-4852
Country	:	US
Telephone Number	:	860-979-1611
Fax Number	:	203-866-3014

Provider Business Practice Location Address
First Line	:	1683 BOSTON TPKE
Second Line	:
City	:	COVENTRY
State	:	CT
Zip	:	06238-1105
Country	:	US
Telephone Number	:	860-498-7093
Fax Number	:	860-498-7096

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	01/26/2016

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