Provider Demographics
NPI:1538699731
Name:CAINGLET, CECILIA MARFIL (PTA)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:MARFIL
Last Name:CAINGLET
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 N COMMERCE DR APT I204
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-4749
Mailing Address - Country:US
Mailing Address - Phone:917-659-9076
Mailing Address - Fax:
Practice Address - Street 1:1258 N COMMERCE DR APT I204
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-4749
Practice Address - Country:US
Practice Address - Phone:917-659-9076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8986734225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT8986734Medicaid