Healthcare Provider Details

I. General information

NPI: 1992705875
Provider Name (Legal Business Name): HELENE CAROLE CAGAN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E 88TH ST
NEW YORK NY
10128-4936
US

IV. Provider business mailing address

319 E 88TH ST
NEW YORK NY
10128-4936
US

V. Phone/Fax

Practice location:
  • Phone: 718-584-7163
  • Fax:
Mailing address:
  • Phone: 212-369-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004185
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: