# DR. MARY T CACCAVO

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134116031
- **Gender:** F
- **Credential:** PH.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 23001132A | IN | Yes |
| 237600000X | Audiologist-Hearing Aid Fitter | 23001132A | IN | — |

## Other

- **Enumeration date:** 10/05/2005
- **Last updated:** 06/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000202141 | BCBS UAW | IN |
| 01 | — | 000000220882 | BCBS UAW | IN |
| 01 | — | 000000220890 | BLUE CROSS BLUE SHIELD | IN |
| 05 | — | 100232400A | — | IN |
| 01 | — | 640004350 | RAILROAD MEDICARE | IN |