Provider Demographics
NPI:1457958274
Name:GUERRA, CAITLIN EILEEN (DPT)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:EILEEN
Last Name:GUERRA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 VETERANS MEMORIAL HWY STE 21
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1534
Mailing Address - Country:US
Mailing Address - Phone:631-348-0959
Mailing Address - Fax:
Practice Address - Street 1:1747 VETERANS MEMORIAL HWY STE 21
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1534
Practice Address - Country:US
Practice Address - Phone:631-348-0959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist