Provider Demographics
NPI:1659555357
Name:MILVA CATALLOZZI PT LLC
Entity Type:Organization
Organization Name:MILVA CATALLOZZI PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MILVA
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:CATALLOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,PT
Authorized Official - Phone:401-353-9100
Mailing Address - Street 1:PO BOX 114099
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-0299
Mailing Address - Country:US
Mailing Address - Phone:401-353-9100
Mailing Address - Fax:401-353-9101
Practice Address - Street 1:1635 MINERAL SPRING AVE
Practice Address - Street 2:SUITE # 200
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4025
Practice Address - Country:US
Practice Address - Phone:401-353-9100
Practice Address - Fax:401-353-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI000986261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy