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General NPI Number Information
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NPI Number | 1548078041
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Entity Type | Individual
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Provider Name | KAILEY M CAIVANO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 66 SUNSET STRIP STE 407
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1362
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Country | US
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Telephone | 973-252-1676
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Fax |
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Provider Business Mailing Address
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Address Line | 86 MASE RD
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City | LAKE HOPATCONG
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State | NJ
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Zip | 07849-2111
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Country | US
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Telephone | 973-309-3339
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ15245500
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License Number State | NJ
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