MEDICARE: DR. KEITH F CAVAYERO DC

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	111N00000X	Chiropractor	X006165	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C061657	OTHER	NY	WC#

General Provider Information

NPI Number	:	1578645271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH F CAVAYERO DC

Provider Business Mailing Address
First Line	:	24 HAMILTON ST
Second Line	:	SUITE 4
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-4226
Country	:	US
Telephone Number	:	518-581-7246
Fax Number	:	518-581-4067

Provider Business Practice Location Address
First Line	:	24 HAMILTON ST
Second Line	:	SUITE 4
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-4226
Country	:	US
Telephone Number	:	518-581-7246
Fax Number	:	518-581-4067

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	10/06/2009

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