MEDICARE: MR. CHARLES HENRY CADY A.T.,C.

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	174400000X	Specialist	000199	NY

General Provider Information

NPI Number	:	1861466542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES HENRY CADY A.T.,C.

Provider Business Mailing Address
First Line	:	7450 EATON RD
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-2412
Country	:	US
Telephone Number	:	315-691-2448
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 EATON RD
Second Line	:
City	:	HAMILTON
State	:	NY
Zip	:	13346-2412
Country	:	US
Telephone Number	:	315-691-2448
Fax Number	:

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	07/08/2007

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