Provider Demographics
NPI:1487027876
Name:ROSARIO, CAITLIN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5871 GROVELAND STATION RD
Mailing Address - Street 2:
Mailing Address - City:MT. MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510
Mailing Address - Country:US
Mailing Address - Phone:585-658-4023
Mailing Address - Fax:585-658-4066
Practice Address - Street 1:5871 GROVELAND STATION RD
Practice Address - Street 2:
Practice Address - City:MT. MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510
Practice Address - Country:US
Practice Address - Phone:585-658-4023
Practice Address - Fax:585-658-4066
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist