Provider Demographics
NPI:1275727497
Name:CATCHUK, NICHOLAS DARCY
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:DARCY
Last Name:CATCHUK
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 1:10 S TREASURE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3509
Mailing Address - Country:US
Mailing Address - Phone:813-569-9191
Mailing Address - Fax:
Practice Address - Street 1:1485 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4525
Practice Address - Country:US
Practice Address - Phone:352-683-9478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3436152W00000X
WAOD00003632152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist