Healthcare Provider Details

I. General information

NPI: 1992880348
Provider Name (Legal Business Name): PATRICK F CAULFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 ROUTE 9W
RAVENA NY
12413
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD STE 203
LATHAM NY
12110-2461
US

V. Phone/Fax

Practice location:
  • Phone: 518-756-7390
  • Fax: 518-756-8030
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number164080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: