Provider Demographics
NPI:1295327708
Name:CATARISANO, VINCENZO (COSMETOLOGIST)
Entity type:Individual
Prefix:
First Name:VINCENZO
Middle Name:
Last Name:CATARISANO
Suffix:
Gender:M
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 E HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-3923
Mailing Address - Country:US
Mailing Address - Phone:585-359-1240
Mailing Address - Fax:
Practice Address - Street 1:2050 E HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-3923
Practice Address - Country:US
Practice Address - Phone:585-359-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22CA0162297335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier