MEDICARE: MRS. MONICA CARACIOLO MSPT

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	225100000X	Physical Therapist	020726-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000077425	OTHER	NY	GHI HMO
2	1995673	OTHER	NY	UNITED HEALTHCARE
3	6698715	OTHER	NY	GHI
4	00000094481	OTHER	NY	BETTER HEALTH ADVANTAGE
5	143405	OTHER	NY	VYTRA
6	823529	OTHER	NY	MPN
7	9544000	OTHER	NY	CIGNA PPO
8	P00031175	OTHER	NY	MCR RR
9	3C3953	OTHER	NY	HEALTHNET
10	QP1091	OTHER	NY	BC/BS
11	20726	OTHER	NY	HIP
12	1737291	OTHER	NY	FIRST HEALTH
13	17401	OTHER	NY	CIGNA ORTHONET, POS
14	9918	OTHER	NY	ACCESS
15	P2778675	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1679579114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONICA CARACIOLO MSPT

Provider Business Mailing Address
First Line	:	2237 WANTAGH AVE
Second Line	:	UNIT A
City	:	WANTAGH
State	:	NY
Zip	:	11793-3945
Country	:	US
Telephone Number	:	516-735-3783
Fax Number	:

Provider Business Practice Location Address
First Line	:	2237A WANTAGH AVE
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-3917
Country	:	US
Telephone Number	:	516-826-0116
Fax Number	:	516-826-0115

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	05/11/2017

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