Provider Demographics
NPI:1235562984
Name:FARRUGGIO, CAITLIN MCDONALD (DPT)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:MCDONALD
Last Name:FARRUGGIO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:718 OLD LIVERPOOL RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-6035
Mailing Address - Country:US
Mailing Address - Phone:315-457-7005
Mailing Address - Fax:315-457-7214
Practice Address - Street 1:718 OLD LIVERPOOL RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-6035
Practice Address - Country:US
Practice Address - Phone:315-457-7005
Practice Address - Fax:315-457-7214
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist