Caccavo, Mary T

Caccavo, Mary T is an individual health care provider with primary practice located at 2122 Scott St. , Lafayette IN 47904-2932. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Caccavo, Mary T can be contacted via phone (765) 448-6226.

Contact Information

Primary practice address
2122 Scott St. Lafayette IN 47904-2932
Phone: (765) 448-6226
Fax: (765) 448-9416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 23001132A Indiana
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 23001132A Indiana

Profile Details

NPI number 1134116031
LBN Legal business name Caccavo, Mary T
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jun 28th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134116031 NPPES
Indiana Other 000000202141 BCBS UAW
Indiana Other 000000220890 BCBS UAW
Indiana Other 000000220890 BCBS UAW
Indiana Other 640004350 BCBS UAW
Indiana MEDICAID 100232400A BCBS UAW
Indiana Other 000000220882 BCBS UAW

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