Healthcare Provider Details

I. General information

NPI: 1720394539
Provider Name (Legal Business Name): MAUREEN CAULFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 PROSPECT AVE
FORT WASHINGTON PA
19034-1325
US

IV. Provider business mailing address

711 PROSPECT AVE
FORT WASHINGTON PA
19034-1325
US

V. Phone/Fax

Practice location:
  • Phone: 215-591-3767
  • Fax:
Mailing address:
  • Phone: 215-591-3767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD052424-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: