Provider Demographics
NPI:1811185317
Name:CATRINO, JOHN PAUL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:CATRINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-3713
Mailing Address - Country:US
Mailing Address - Phone:215-557-0564
Mailing Address - Fax:
Practice Address - Street 1:1831 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-3713
Practice Address - Country:US
Practice Address - Phone:215-557-0564
Practice Address - Fax:215-557-0567
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4501370001Medicare NSC