MEDICARE: MRS. CAITLIN VLACHOS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	022966-1	NY

General Provider Information

NPI Number	:	1578808929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAITLIN VLACHOS M.S.

Provider Business Mailing Address
First Line	:	200 FOREST AVE
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-5131
Country	:	US
Telephone Number	:	631-376-7300
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 FOREST AVE
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-5131
Country	:	US
Telephone Number	:	631-376-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2012
Last Update Date	:	07/13/2023

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Directions to “ MRS. CAITLIN VLACHOS M.S.” Practice Location

Language	Start Address	Practice Location

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