Provider Demographics
NPI:1336313048
Name:CUTCHOGUE WALK-IN MEDICAL CARE PLLC
Entity type:Organization
Organization Name:CUTCHOGUE WALK-IN MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CATAPANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-734-5505
Mailing Address - Street 1:32645 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:CUTCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11935-1364
Mailing Address - Country:US
Mailing Address - Phone:631-734-5505
Mailing Address - Fax:
Practice Address - Street 1:32645 MAIN RD
Practice Address - Street 2:
Practice Address - City:CUTCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11935-1364
Practice Address - Country:US
Practice Address - Phone:631-734-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty