Provider Demographics
NPI:1053369819
Name:CATALA, EDGAR (MD)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:
Last Name:CATALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SCOVILL ST 101
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1127
Mailing Address - Country:US
Mailing Address - Phone:203-709-5680
Mailing Address - Fax:203-709-5688
Practice Address - Street 1:80 PHOENIX AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1418
Practice Address - Country:US
Practice Address - Phone:203-756-8459
Practice Address - Fax:203-591-8311
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT027528207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001275280Medicaid
CT001275280Medicaid
CTD80844Medicare UPIN