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Contact Information

MARY T CACCAVO, PhD
2122 SCOTT ST.
LAFAYETTE, IN47904-2932
 Phone: 765-448-6226
 Fax: 765-448-9416
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Audiologist

231H00000X 64 Audiologist
 

Audiologist-Hearing Aid Fitter

237600000X
Indicates primary specialty

NPI Profile & details for MARY T CACCAVO · (Female)

NPI Number 1134116031
Status Active
Credentials PhD
Entity Individual
Enumeration date 10/05/2005
Last updated 06/28/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 23001132A
  • IN Medicaid 100232400A
  • IN Other 000000202141 BCBS UAW
  • IN Other 000000220882 BCBS UAW
  • IN Other 000000220890 BLUE CROSS BLUE SHIELD
  • IN Other 000000220890 FEDERAL BCBS
  • IN Other 640004350 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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