Provider Demographics
NPI:1386648210
Name:CATALANO, DOMINICK R (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:R
Last Name:CATALANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 E RICE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4341
Mailing Address - Country:US
Mailing Address - Phone:330-829-4057
Mailing Address - Fax:330-821-2535
Practice Address - Street 1:264 E RICE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4341
Practice Address - Country:US
Practice Address - Phone:330-829-4057
Practice Address - Fax:330-821-2535
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-0432-C207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCA0570266Medicare ID - Type Unspecified
A82188Medicare UPIN
OH0552923Medicare ID - Type Unspecified