MEDICARE: DR. CHARLES F CALEY PHARM.D., BCPP

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	1835P1300X	Psychiatric Pharmacist	PCT.9050	CT

General Provider Information

NPI Number	:	1205833936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES F CALEY PHARM.D., BCPP

Provider Business Mailing Address
First Line	:	200 RETREAT AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-3309
Country	:	US
Telephone Number	:	860-545-7228
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 RETREAT AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-3309
Country	:	US
Telephone Number	:	860-545-7228
Fax Number	:

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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