Provider Demographics
NPI:1518436146
Name:BERTANI, MARIA CATALINA (CM)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CATALINA
Last Name:BERTANI
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 RUGBY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2410
Mailing Address - Country:US
Mailing Address - Phone:646-510-5372
Mailing Address - Fax:
Practice Address - Street 1:9004 161ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6141
Practice Address - Country:US
Practice Address - Phone:718-523-2123
Practice Address - Fax:718-523-5833
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001903367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife