Provider Demographics
NPI:1124481759
Name:CATANZARO, MICHAEL PETER (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PETER
Last Name:CATANZARO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4137
Mailing Address - Country:US
Mailing Address - Phone:151-666-3033
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2021-05-20
Deactivation Date:2018-04-10
Deactivation Code:
Reactivation Date:2018-04-21
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY308946207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program