Healthcare Provider Details

I. General information

NPI: 1376224915
Provider Name (Legal Business Name): CAITLIN PACILEO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 SAYBROOK RD STE 2
MIDDLETOWN CT
06457-4770
US

IV. Provider business mailing address

536 SAYBROOK RD STE 2
MIDDLETOWN CT
06457-4770
US

V. Phone/Fax

Practice location:
  • Phone: 860-358-2220
  • Fax: 860-358-2222
Mailing address:
  • Phone: 413-478-3382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number6779
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number6779
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: