Provider Demographics
NPI:1124064399
Name:CATANDO, R. BRUCE (OD)
Entity type:Individual
Prefix:DR
First Name:R.
Middle Name:BRUCE
Last Name:CATANDO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WESTTOWN RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4978
Mailing Address - Country:US
Mailing Address - Phone:610-696-7277
Mailing Address - Fax:610-696-8599
Practice Address - Street 1:110 WESTTOWN RD
Practice Address - Street 2:SUITE 120
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4978
Practice Address - Country:US
Practice Address - Phone:610-696-7277
Practice Address - Fax:610-696-8599
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000161152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU17083Medicare UPIN
PA669090Medicare ID - Type Unspecified