Healthcare Provider Details

I. General information

NPI: 1831089960
Provider Name (Legal Business Name): CAROLINE ROSE CAHILL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N LAKE DR
MILWAUKEE WI
53211-4508
US

IV. Provider business mailing address

3046 FARM WALK RD
YORKTOWN HEIGHTS NY
10598-3243
US

V. Phone/Fax

Practice location:
  • Phone: 414-585-1000
  • Fax:
Mailing address:
  • Phone: 914-215-3199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: