Provider Demographics
NPI:1134578750
Name:BORRIELLO, CAITLIN MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:MARIE
Last Name:BORRIELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:MARIE
Other - Last Name:DONAHUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Mailing Address - Street 2:HEALTH SCIENCES CENTER LEVEL 16 ROOM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-1060
Mailing Address - Fax:631-444-1054
Practice Address - Street 1:200 MOTOR PKWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5100
Practice Address - Country:US
Practice Address - Phone:631-444-9600
Practice Address - Fax:631-444-9621
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-04
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30-307387363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner