Provider Demographics
NPI:1902201098
Name:HENDERSON, CAITLIN (MLP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MLP
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Other - Last Name:
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Mailing Address - Street 1:500 MONTAUK HIGHWAY SUITE W
Mailing Address - Street 2:SARAH SCHWARTZ MD PLLC
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795
Mailing Address - Country:US
Mailing Address - Phone:631-661-5511
Mailing Address - Fax:631-661-5516
Practice Address - Street 1:500 MONTAUK HIGHWAY SUITE W
Practice Address - Street 2:SARAH SCHWARTZ MD PLLC
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795
Practice Address - Country:US
Practice Address - Phone:631-661-5511
Practice Address - Fax:631-661-5516
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF421154-1363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health