Provider Demographics
NPI:1811416894
Name:CATJAKIS, NICHOLAS CHARLES (PT)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:CHARLES
Last Name:CATJAKIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 BIRNIE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1121
Mailing Address - Country:US
Mailing Address - Phone:413-233-1292
Mailing Address - Fax:413-846-4742
Practice Address - Street 1:265 BENTON DR
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-3219
Practice Address - Country:US
Practice Address - Phone:413-233-1292
Practice Address - Fax:413-846-4742
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231932251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic