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General NPI Number Information
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NPI Number | 1649672213
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Entity Type | Individual
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Provider Name | DIANE CAGGIANO
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 1227 MONTAUK HWY UNIT 2
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City | OAKDALE
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State | NY
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Zip | 11769-1492
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Country | US
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Telephone | 631-218-1545
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Fax | 631-218-2650
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Provider Business Mailing Address
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Address Line | 65 BROWNS RIVER ROAD 2
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City | BAYPORT
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State | NY
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Zip | 11705-2005
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Country | US
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Telephone | 631-472-0804
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Fax | 631-218-1545
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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