Basic Information
Provider Information
NPI: 1124344924
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAGGIANO
FirstName: ASHLEY
MiddleName: NORMAN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NORMAN
OtherFirstName: ASHLEY
OtherMiddleName: E.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 118 N BEDFORD RD
Address2: SUITE 200
City: MOUNT KISCO
State: NY
PostalCode: 105492553
CountryCode: US
TelephoneNumber: 9146668866
FaxNumber: 9146666777
Practice Location
Address1: 118 N BEDFORD RD
Address2: SUITE 200
City: MOUNT KISCO
State: NY
PostalCode: 105492553
CountryCode: US
TelephoneNumber: 9146668866
FaxNumber: 9146666777
Other Information
ProviderEnumerationDate: 04/19/2010
LastUpdateDate: 02/03/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X247016-1NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0336607005NY MEDICAID


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