Provider Demographics
NPI:1740370444
Name:CATALANO, EDISON (MD)
Entity type:Individual
Prefix:
First Name:EDISON
Middle Name:
Last Name:CATALANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-342-2921
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2506
Practice Address - Fax:856-968-8312
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA30813207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3998703Medicaid
1010472OtherHORIZON NJ HEALTH
P770359OtherOXFORD
13563OtherUNIVERSITY HEALTHPLAN
0470131000OtherAMERIHEALTH HMO, KEYSTONE, IBC
010003887OtherAMERICHOICE
NJ220005423OtherRR MEDICARE
567560OtherUNITED HEALTHCARE
639803OtherAMERIHEALTH PPO
XK5414OtherHEALTHNET
NJ3998703Medicaid
0470131000OtherAMERIHEALTH HMO, KEYSTONE, IBC
1010472OtherHORIZON NJ HEALTH