Healthcare Provider Details

I. General information

NPI: 1407710346
Provider Name (Legal Business Name): TERESA CAOILI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 AVENUE A
CORNWALL ON HUDSON NY
12520-1002
US

IV. Provider business mailing address

10 HOGAN DR
LAGRANGEVILLE NY
12540-6312
US

V. Phone/Fax

Practice location:
  • Phone: 845-237-7152
  • Fax:
Mailing address:
  • Phone: 845-206-3197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number366573
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: