Provider Demographics
NPI:1144602830
Name:CADET, KAOLITA STEPHANIE
Entity Type:Individual
Prefix:
First Name:KAOLITA
Middle Name:STEPHANIE
Last Name:CADET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:K
Other - Last Name:CADET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 E BETHPAGE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4228
Mailing Address - Country:US
Mailing Address - Phone:718-676-9572
Mailing Address - Fax:
Practice Address - Street 1:2922 NOSTRAND AVE
Practice Address - Street 2:APT. 3B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1859
Practice Address - Country:US
Practice Address - Phone:718-676-9572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator