Healthcare Provider Details

I. General information

NPI: 1427379346
Provider Name (Legal Business Name): AMY CAGGIULA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 L ST NW SUITE 450
WASHINGTON DC
20037
US

IV. Provider business mailing address

2120 L ST NW SUITE 450
WASHINGTON DC
20037
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD043961
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: