Provider Demographics
NPI:1457593477
Name:LE, CATVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATVAN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANNY
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33 CLYDE RD
Mailing Address - Street 2:SUITES 105-106
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5032
Mailing Address - Country:US
Mailing Address - Phone:732-873-6868
Mailing Address - Fax:732-873-6869
Practice Address - Street 1:33 CLYDE RD
Practice Address - Street 2:SUITES 105-106
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5032
Practice Address - Country:US
Practice Address - Phone:732-873-6868
Practice Address - Fax:732-873-6869
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA08859900208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program