Provider Demographics
NPI:1265276570
Name:OGRAM BUCKLEY, CAITLIN MICHELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:MICHELLE
Last Name:OGRAM BUCKLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:MICHELLE
Other - Last Name:OGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3213 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-2723
Mailing Address - Country:US
Mailing Address - Phone:610-574-7231
Mailing Address - Fax:
Practice Address - Street 1:666 PLAINSBORO RD STE 2000C
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3048
Practice Address - Country:US
Practice Address - Phone:856-616-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS02259103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist