MEDICARE: ATHENA J CAI PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	016499	NY

General Provider Information

NPI Number	:	1083057608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATHENA J CAI PA

Provider Business Mailing Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3195
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:	718-996-2888

Provider Business Practice Location Address
First Line	:	8321 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3195
Country	:	US
Telephone Number	:	718-996-9888
Fax Number	:	718-996-2888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2013
Last Update Date	:	02/12/2026

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