Provider Demographics
NPI:1205890886
Name:CATALDI, BETHANY (DO)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:CATALDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 958
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-0958
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2203 45TH ST
Practice Address - Street 2:SUITE 'B'
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2601
Practice Address - Country:US
Practice Address - Phone:219-836-4820
Practice Address - Fax:219-836-5186
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002695A207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200841030 AMedicaid
IN200841030 AMedicaid
IN249060AMedicare PIN