Provider Demographics
NPI:1508257171
Name:CAGLIUSO, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CAGLIUSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PARK DR APT 107
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-6014
Mailing Address - Country:US
Mailing Address - Phone:845-220-8905
Mailing Address - Fax:
Practice Address - Street 1:66 MIDDLEBUSH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4098
Practice Address - Country:US
Practice Address - Phone:845-632-6775
Practice Address - Fax:845-632-6777
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist