Provider Demographics
NPI:1023776994
Name:CAMISA, CAITLIN ELISABETH (LAC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ELISABETH
Last Name:CAMISA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EVERGREEN PL UNIT D
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4012
Mailing Address - Country:US
Mailing Address - Phone:973-998-7737
Mailing Address - Fax:973-998-3339
Practice Address - Street 1:1 EVERGREEN PL UNIT D
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4012
Practice Address - Country:US
Practice Address - Phone:973-998-7737
Practice Address - Fax:973-998-3339
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00156900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist