Provider Demographics
NPI:1689330276
Name:CONFORTI, CAITLIN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CONFORTI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 SWAN PL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-6800
Mailing Address - Country:US
Mailing Address - Phone:631-434-2467
Mailing Address - Fax:631-972-1528
Practice Address - Street 1:48 SWAN PL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-6800
Practice Address - Country:US
Practice Address - Phone:516-434-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY775745-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse