Healthcare Provider Details

I. General information

NPI: 1639590532
Provider Name (Legal Business Name): CAITLIN SAXTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 UNION AVENUE
AQUEBOGUE NY
11931
US

IV. Provider business mailing address

PO BOX 2035
AQUEBOGUE NY
11931-2035
US

V. Phone/Fax

Practice location:
  • Phone: 631-830-2421
  • Fax:
Mailing address:
  • Phone: 631-830-2421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number022637-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: