Individual
TINA CAIAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C/ATC09/
Contact information
Practice address
US ARMY/SCHOFIELD BARRACKS, SCHOFIELD, HI 96787
(808) 433-8626
Mailing address
PO BOX 837, BANGOR, PA 18013-0837
(845) 926-2421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010066-1
NY
363AS0400X
Surgical Physician Assistant
010066-1
NY
Other
Enumeration date
05/18/2006
Last updated
06/12/2015
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