Provider Demographics
NPI:1104540004
Name:SUEIRO, CAITLYNN ROSE
Entity type:Individual
Prefix:
First Name:CAITLYNN
Middle Name:ROSE
Last Name:SUEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 US HIGHWAY 1 N
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2629
Mailing Address - Country:US
Mailing Address - Phone:732-510-1132
Mailing Address - Fax:
Practice Address - Street 1:670 US HIGHWAY 1 N
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2629
Practice Address - Country:US
Practice Address - Phone:732-510-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator