Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 18461 | MA |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 18923 | MA |
NPI | 1770505166 |
---|---|
Provider Name | Dr. John C Cataudella |
First Address | Norwell, MA 02061-1740 |
Second Address | Norwell, MA 02061-1742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U56054 | (02) | MA |
U62368 | (02) | MA |