Provider Demographics
NPI:1124212634
Name:CATALAN, JUDITH A (NP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:CATALAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:43 HIGH ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2097
Practice Address - Country:US
Practice Address - Phone:508-973-5919
Practice Address - Fax:508-973-5916
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN176740363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110088422AMedicaid
RI1124212634Medicaid
MAS400258584Medicare PIN