Provider Demographics
NPI:1851547814
Name:CATANESE, KRISTY L
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:L
Last Name:CATANESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EAST MAIN ST
Mailing Address - Street 2:P.O. BOX 149
Mailing Address - City:PANAMA
Mailing Address - State:NY
Mailing Address - Zip Code:14767-0149
Mailing Address - Country:US
Mailing Address - Phone:716-782-3774
Mailing Address - Fax:
Practice Address - Street 1:12 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:PANAMA
Practice Address - State:NY
Practice Address - Zip Code:14767-0149
Practice Address - Country:US
Practice Address - Phone:716-782-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014892-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist