Provider Demographics
NPI:1831815794
Name:CAETTA, MN MITZ
Entity type:Individual
Prefix:
First Name:MN MITZ
Middle Name:
Last Name:CAETTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 STATE RD UNIT 3821
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-4845
Mailing Address - Country:US
Mailing Address - Phone:234-738-5612
Mailing Address - Fax:
Practice Address - Street 1:4694 WYOGA LAKE RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1012
Practice Address - Country:US
Practice Address - Phone:234-738-5612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide