Provider Demographics
NPI:1205919230
Name:CATANIA, INGRID LYNN (DC)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:LYNN
Last Name:CATANIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 PINES LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5011
Mailing Address - Country:US
Mailing Address - Phone:973-839-6923
Mailing Address - Fax:973-482-6922
Practice Address - Street 1:535 N 7TH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2423
Practice Address - Country:US
Practice Address - Phone:973-483-7246
Practice Address - Fax:973-482-6922
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00380200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5404606Medicaid