Provider Demographics
NPI:1053873836
Name:CATAUDELLA, JOSEPH N (MS ATC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:CATAUDELLA
Suffix:
Gender:M
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 DONNER PASS RD
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4848
Mailing Address - Country:US
Mailing Address - Phone:732-865-2146
Mailing Address - Fax:
Practice Address - Street 1:19749 BOREAL RIDGE RD
Practice Address - Street 2:
Practice Address - City:SODA SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95728-9572
Practice Address - Country:US
Practice Address - Phone:732-865-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT002502002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer