Provider Demographics
NPI:1952044265
Name:DEPAULO, CAITLIN MARIA
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:MARIA
Last Name:DEPAULO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-6845
Mailing Address - Country:US
Mailing Address - Phone:646-385-5863
Mailing Address - Fax:
Practice Address - Street 1:354 SOUTH AVE E
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1788
Practice Address - Country:US
Practice Address - Phone:908-233-8065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01295100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health