Provider Demographics
NPI:1942994785
Name:CATANUTO, NICOLE ANN
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:ANN
Last Name:CATANUTO
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 1:559 CENTER CHICOT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4005
Mailing Address - Country:US
Mailing Address - Phone:516-906-3347
Mailing Address - Fax:
Practice Address - Street 1:559 CENTER CHICOT AVE
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4005
Practice Address - Country:US
Practice Address - Phone:516-906-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311905164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse