Provider Demographics
NPI:1356177034
Name:ROCHE, CAITLYN ELIZABETH
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ELIZABETH
Last Name:ROCHE
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 1:764 VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1723
Mailing Address - Country:US
Mailing Address - Phone:646-371-5405
Mailing Address - Fax:
Practice Address - Street 1:3631 HILL BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1501
Practice Address - Country:US
Practice Address - Phone:845-519-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist