Healthcare Provider Details

I. General information

NPI: 1457217713
Provider Name (Legal Business Name): CAITLIN WOLF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PARK ST STE 2W
PEEKSKILL NY
10566-3491
US

IV. Provider business mailing address

1010 PARK ST STE 2W
PEEKSKILL NY
10566-3491
US

V. Phone/Fax

Practice location:
  • Phone: 914-302-9769
  • Fax:
Mailing address:
  • Phone: 914-302-9769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number033884
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: