Provider Demographics
NPI:1851626121
Name:CAGGIANO, JESSICA M (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:CAGGIANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2621
Mailing Address - Country:US
Mailing Address - Phone:732-970-4974
Mailing Address - Fax:732-970-4088
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2621
Practice Address - Country:US
Practice Address - Phone:732-970-4974
Practice Address - Fax:732-970-4088
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01318900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation