Provider Demographics
NPI:1326846718
Name:CATANANZI, NICHOLAS TYLER
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:TYLER
Last Name:CATANANZI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 PAMELA CT
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1232
Mailing Address - Country:US
Mailing Address - Phone:732-543-4064
Mailing Address - Fax:
Practice Address - Street 1:65 MECHANIC ST STE L-5
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1868
Practice Address - Country:US
Practice Address - Phone:732-747-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02317400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist