Provider Demographics
NPI:1063274538
Name:CATTAFI, CARA ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:ANNE
Last Name:CATTAFI
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 1:100 W KINGFISHER WAY
Mailing Address - Street 2:
Mailing Address - City:LAVALLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:08735-1224
Mailing Address - Country:US
Mailing Address - Phone:848-251-4279
Mailing Address - Fax:
Practice Address - Street 1:100 W KINGFISHER WAY
Practice Address - Street 2:
Practice Address - City:LAVALLETTE
Practice Address - State:NJ
Practice Address - Zip Code:08735-1224
Practice Address - Country:US
Practice Address - Phone:848-251-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00833500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant