Provider Demographics
NPI:1568988517
Name:CAUGHLAN, MOLLY KATHLEEN (PT , DPT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:KATHLEEN
Last Name:CAUGHLAN
Suffix:
Gender:F
Credentials:PT , DPT
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:KATHLEEN
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:68 JAY ST STE 609
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-8362
Mailing Address - Country:US
Mailing Address - Phone:929-203-0750
Mailing Address - Fax:929-232-2032
Practice Address - Street 1:68 JAY ST STE 609
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-8362
Practice Address - Country:US
Practice Address - Phone:929-203-0750
Practice Address - Fax:929-232-2032
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041765-01225100000X
NY041765-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist