Provider Demographics
NPI:1124788401
Name:KOCABAY, CAROLINE N (OTR/L)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:N
Last Name:KOCABAY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 LIGHTHOUSE PT E STE 402
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4769
Mailing Address - Country:US
Mailing Address - Phone:443-599-4000
Mailing Address - Fax:
Practice Address - Street 1:2700 LIGHTHOUSE PT E STE 402
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4769
Practice Address - Country:US
Practice Address - Phone:716-725-1805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist