Provider Demographics
NPI:1194200022
Name:CATRAMBONE, RICHARD VITO
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:VITO
Last Name:CATRAMBONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02465-1127
Mailing Address - Country:US
Mailing Address - Phone:857-636-8150
Mailing Address - Fax:
Practice Address - Street 1:78 FALMOUTH RD.
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-1127
Practice Address - Country:US
Practice Address - Phone:857-636-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100904104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker