MEDICARE: MRS. AMY LIZABETH CAIVANO MA,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	0102811	NY

General Provider Information

NPI Number	:	1205088127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY LIZABETH CAIVANO MA,CCC-SLP

Provider Business Mailing Address
First Line	:	20 ARDSLEY DR
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-4223
Country	:	US
Telephone Number	:	845-634-1098
Fax Number	:	845-634-1098

Provider Business Practice Location Address
First Line	:	20 ARDSLEY DR
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-4223
Country	:	US
Telephone Number	:	845-634-1098
Fax Number	:	845-634-1098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	10/22/2008

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