Provider Demographics
NPI:1104451400
Name:HORGAN, CAITLYN A (PA-C)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:A
Last Name:HORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 KENMORE RD
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1462
Mailing Address - Country:US
Mailing Address - Phone:973-897-6532
Mailing Address - Fax:
Practice Address - Street 1:12 KENMORE RD
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1462
Practice Address - Country:US
Practice Address - Phone:973-897-6532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant