Healthcare Provider Details

I. General information

NPI: 1356340657
Provider Name (Legal Business Name): JAMES A CAFFREY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 05/22/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3369 STATE ROUTE 100
MACUNGIE PA
18062-9613
US

IV. Provider business mailing address

755 MEMORIAL PKWY
PHILLIPSBURG NJ
08865-2748
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8111
  • Fax:
Mailing address:
  • Phone: 908-454-6303
  • Fax: 908-454-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS008015L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB56558
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS008015L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: