Provider Demographics
NPI:1417061623
Name:CATANESE, ROBERT A (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:CATANESE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 EXECUTIVE PARK NW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2723
Mailing Address - Country:US
Mailing Address - Phone:423-339-3996
Mailing Address - Fax:423-479-9682
Practice Address - Street 1:2775 EXECUTIVE PARK NW
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2723
Practice Address - Country:US
Practice Address - Phone:423-339-3996
Practice Address - Fax:423-479-9682
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1361103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3681820Medicare Oscar/Certification