Provider Demographics
NPI:1902969918
Name:CAICO, CAROL A (PHD NP)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:CAICO
Suffix:
Gender:F
Credentials:PHD NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 WYANET ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-3010
Mailing Address - Country:US
Mailing Address - Phone:516-826-0725
Mailing Address - Fax:
Practice Address - Street 1:165 FROEHLICH FARM BLVD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2906
Practice Address - Country:US
Practice Address - Phone:516-364-7405
Practice Address - Fax:516-364-7410
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360277363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7599999OtherGHI
NY9205274006OtherCIGNA
7599999OtherGHI
NY9205274006OtherCIGNA