Provider Demographics
NPI:1669186474
Name:CERASANI, CATRINA (PA-C)
Entity type:Individual
Prefix:
First Name:CATRINA
Middle Name:
Last Name:CERASANI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-3227
Mailing Address - Country:US
Mailing Address - Phone:732-338-1508
Mailing Address - Fax:
Practice Address - Street 1:11 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-3227
Practice Address - Country:US
Practice Address - Phone:732-388-1508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant