Provider Demographics
NPI:1659358919
Name:CATALUSCI, LOUIS R (PT)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:R
Last Name:CATALUSCI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SOUTH PLANK RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5758
Mailing Address - Country:US
Mailing Address - Phone:845-566-4303
Mailing Address - Fax:845-566-4255
Practice Address - Street 1:211 SOUTH PLANK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5758
Practice Address - Country:US
Practice Address - Phone:845-566-4303
Practice Address - Fax:845-566-4255
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11494174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQQ7581OtherEMPIRE BLUE CROSS BLUE SHIELD
NY01572412Medicaid
NY01572412Medicaid