Provider Demographics
NPI:1851577266
Name:MAURIZI, CATHERINE J
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:J
Last Name:MAURIZI
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 1:29 SANDALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4826
Mailing Address - Country:US
Mailing Address - Phone:631-366-2878
Mailing Address - Fax:
Practice Address - Street 1:29 SANDALWOOD DR
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4826
Practice Address - Country:US
Practice Address - Phone:631-366-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY539017-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02734669Medicaid