Provider Demographics
NPI:1699334177
Name:CANEVARI, CAITLYN MARGARET (MS CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:CAITLYN
Middle Name:MARGARET
Last Name:CANEVARI
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:MS
Other - First Name:CAITLYN
Other - Middle Name:MARGARET
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 BLUEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12594-1632
Mailing Address - Country:US
Mailing Address - Phone:845-249-5538
Mailing Address - Fax:
Practice Address - Street 1:470 MAMARONECK AVE STE 204
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1839
Practice Address - Country:US
Practice Address - Phone:914-421-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist