Provider Demographics
NPI:1275760514
Name:CATALANO, AMANDA (LPN)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:
Last Name:CATALANO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:NON APLICABLE
Other - Middle Name:
Other - Last Name:NON APLICABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NON APLICABLE
Mailing Address - Street 1:2171 N FRENCH RD APT 4
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1128
Mailing Address - Country:US
Mailing Address - Phone:716-465-5712
Mailing Address - Fax:
Practice Address - Street 1:2171 N FRENCH RD APT 4
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1128
Practice Address - Country:US
Practice Address - Phone:716-465-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-13
Last Update Date:2009-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297216164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI DONT HAVE ONE YETMedicaid