Provider Demographics
NPI:1811293715
Name:CAROLINE TIGLIO, DPM, PC
Entity type:Organization
Organization Name:CAROLINE TIGLIO, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-325-5103
Mailing Address - Street 1:719 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3432
Mailing Address - Country:US
Mailing Address - Phone:914-325-5103
Mailing Address - Fax:
Practice Address - Street 1:220 GRACE CHURCH ST
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-5162
Practice Address - Country:US
Practice Address - Phone:914-939-7828
Practice Address - Fax:914-939-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006278213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV10978Medicare UPIN