Provider Demographics
NPI:1699755801
Name:CATANESE, VINCENT J (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:J
Last Name:CATANESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 N BEERS ST
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1528
Mailing Address - Country:US
Mailing Address - Phone:732-264-8484
Mailing Address - Fax:732-264-4324
Practice Address - Street 1:733 N BEERS ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1528
Practice Address - Country:US
Practice Address - Phone:732-264-8484
Practice Address - Fax:732-264-4324
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ595501AVPMedicare PIN
NJC63294Medicare UPIN