Provider Demographics
NPI:1720426737
Name:CATAQUET, VIRNA (VIRNA CATAQUET)
Entity Type:Individual
Prefix:
First Name:VIRNA
Middle Name:
Last Name:CATAQUET
Suffix:
Gender:F
Credentials:VIRNA CATAQUET
Other - Prefix:
Other - First Name:VIRNA RN PC
Other - Middle Name:
Other - Last Name:CATAQUET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:14930 88TH ST APT 4K
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1421
Mailing Address - Country:US
Mailing Address - Phone:347-453-9220
Mailing Address - Fax:
Practice Address - Street 1:14930 88TH ST APT 4K
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-1421
Practice Address - Country:US
Practice Address - Phone:347-453-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4944421163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNYMedicaid