MEDICARE: CATHERINE DIMALANTA P.T.

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	40QA00922600	NJ

General Provider Information

NPI Number	:	1720155872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE DIMALANTA P.T.

Provider Business Mailing Address
First Line	:	3 REGAL CT
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1082 SAINT GEORGES AVE
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-2664
Country	:	US
Telephone Number	:	732-388-4787
Fax Number	:

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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