Provider Demographics
NPI:1356063366
Name:CACOILO, CRISTINA
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CACOILO
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 1:16 SHERYL DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1369
Mailing Address - Country:US
Mailing Address - Phone:908-787-5673
Mailing Address - Fax:
Practice Address - Street 1:373 PARK AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1152
Practice Address - Country:US
Practice Address - Phone:908-322-3202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist