Provider Demographics
NPI:1295187920
Name:CACIOPPO, CARA
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:CACIOPPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 CHESTNUT ST
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3111
Mailing Address - Country:US
Mailing Address - Phone:215-615-2989
Mailing Address - Fax:
Practice Address - Street 1:3930 CHESTNUT ST
Practice Address - Street 2:FLOOR 3
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3111
Practice Address - Country:US
Practice Address - Phone:215-615-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS