Provider Demographics
NPI:1215974456
Name:CATOGGIO, JEANETTE E (PT)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:E
Last Name:CATOGGIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 WANAQUE AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2103
Mailing Address - Country:US
Mailing Address - Phone:973-839-6801
Mailing Address - Fax:973-839-7293
Practice Address - Street 1:223 WANAQUE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-2103
Practice Address - Country:US
Practice Address - Phone:973-839-6801
Practice Address - Fax:973-839-7293
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA03361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ042945BBWMedicare PIN