Provider Demographics
NPI:1700645090
Name:CATALANO, MEGHAN LYNE
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LYNE
Last Name:CATALANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29044 ELMIRA ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3129
Mailing Address - Country:US
Mailing Address - Phone:734-837-1284
Mailing Address - Fax:
Practice Address - Street 1:36975 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1871
Practice Address - Country:US
Practice Address - Phone:734-464-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5502008211225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant