Provider Demographics
NPI:1881699213
Name:CAUCCI, DESIREA D (DPT)
Entity type:Individual
Prefix:DR
First Name:DESIREA
Middle Name:D
Last Name:CAUCCI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:217 S TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-3413
Mailing Address - Country:US
Mailing Address - Phone:215-630-9797
Mailing Address - Fax:610-828-7505
Practice Address - Street 1:814 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1709
Practice Address - Country:US
Practice Address - Phone:610-828-7595
Practice Address - Fax:610-828-7505
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5630094OtherFIRST HEALTH
PAC01732275OtherHIGHMARK BLUE SHIELD
PA1417588OtherHIGHMARK BS INDIVIDUAL
PA3498858OtherAETNA NON-PARTICIPATING #
PA737511OtherNCPPO
PA7385670OtherAETNA WC INDIVIDUAL
PA8279722OtherCIGNA
PA1732275OtherHIGHMARK BS GROUP #
PA700260OtherUNITED HEALTHCARE/ACN GR
PA017588OtherAMERIHEALTH ADMINISTRATOR
PA2402306OtherINDEPENDENCE BC GROUP #
PA7051525OtherAETNA WORKERS COMP
PA0220700OtherORTHONET
PA2103996000OtherINDEPENDENCE BC INDIVIDUA
PA017588OtherAMERIHEALTH ADMINISTRATOR
PA700260OtherUNITED HEALTHCARE/ACN GR