Healthcare Provider Details

I. General information

NPI: 1942229422
Provider Name (Legal Business Name): ELENA S CAOILI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 OLD STATE ROUTE 74 SUITE 4
CINCINNATI OH
45244-4238
US

IV. Provider business mailing address

473 OLD STATE ROUTE 74 SUITE 4
CINCINNATI OH
45244-4238
US

V. Phone/Fax

Practice location:
  • Phone: 513-528-1505
  • Fax: 513-528-5982
Mailing address:
  • Phone: 513-528-1505
  • Fax: 513-528-5982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3506486C
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: