Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 02002695A | IN |
NPI | 1205890886 |
---|---|
Provider Name | Dr. Bethany Cataldi |
First Address | Schererville, IN 46375-0958 |
Second Address | Highland, IN 46322-2601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 15/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200841030 A | (05) | IN |
I70916 | (02) | IN |