Provider Demographics
NPI:1427002583
Name:TIGLIO, CAROLINE (DPM)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:TIGLIO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3432
Mailing Address - Country:US
Mailing Address - Phone:732-574-1777
Mailing Address - Fax:732-574-2707
Practice Address - Street 1:719 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3432
Practice Address - Country:US
Practice Address - Phone:914-325-5103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006278213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV10978Medicare UPIN