Healthcare Provider Details

I. General information

NPI: 1093704595
Provider Name (Legal Business Name): JOSEPH F MCCAFFREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4206 MEDICAL CENTER DR SUITE 206
FAYETTEVILLE NY
13066
US

IV. Provider business mailing address

27 FENNELL ST SUITE B #299
SKANEATELES NY
13152
US

V. Phone/Fax

Practice location:
  • Phone: 315-329-7770
  • Fax: 315-329-7772
Mailing address:
  • Phone: 315-253-3632
  • Fax: 315-253-3632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number143680
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: