Provider Demographics
NPI:1528180809
Name:CAVALIERE, CAROLYN JEAN (DPT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JEAN
Last Name:CAVALIERE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:C
Other - Last Name:MASELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:124 HITCHCOCK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2016
Practice Address - Country:US
Practice Address - Phone:860-747-9441
Practice Address - Fax:860-747-8597
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist