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General NPI Number Information
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NPI Number | 1407127715
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Entity Type | Individual
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Provider Name | CAROLINE CAHALAN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 382 MAIN ST
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3181
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Country | US
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Telephone | 516-767-7216
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Fax |
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Provider Business Mailing Address
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Address Line | 5 YORKSHIRE AVE
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City | STONY BROOK
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State | NY
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Zip | 11790-1331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 428818101
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License Number State | NY
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