Provider Demographics
NPI:1023344223
Name:CATUCCIO, DANIEL J (RPT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:CATUCCIO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:181 PATRICIA M GENOVA DR
Mailing Address - Street 2:5TH FLOOR EASTERN REHABILITATION NETWORK
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-1500
Mailing Address - Country:US
Mailing Address - Phone:860-667-5494
Mailing Address - Fax:
Practice Address - Street 1:499 FARMINGTON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1943
Practice Address - Country:US
Practice Address - Phone:860-667-5494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT007476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist