Provider Demographics
NPI:1447311915
Name:CATALETTO, MAURO M (MD)
Entity type:Individual
Prefix:
First Name:MAURO
Middle Name:M
Last Name:CATALETTO
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 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 470
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:516-248-4488
Mailing Address - Fax:516-248-1727
Practice Address - Street 1:200 OLD COUNTRY RD
Practice Address - Street 2:SUITE 470
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-248-4488
Practice Address - Fax:516-248-1727
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149148207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY42D201Medicare ID - Type Unspecified
NYC09693Medicare UPIN