1871669143 NPI number — DANYELLE L CAETI MD

Table of content: DANYELLE L CAETI MD (NPI 1871669143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871669143 NPI number — DANYELLE L CAETI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAETI
Provider First Name:
DANYELLE
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871669143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1030 PRESIDENT AVE
Provider Second Line Business Mailing Address:
SUITE 2001
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720-5923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-679-6833
Provider Business Mailing Address Fax Number:
508-678-2200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1030 PRESIDENT AVE
Provider Second Line Business Practice Location Address:
SUITE 2001
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720-5923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-679-6833
Provider Business Practice Location Address Fax Number:
508-678-2200
Provider Enumeration Date:
11/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  042146 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001421461 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06-0873781 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0873781 . This is a "GREAT WEST" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0873781 . This is a "HUMANA CHOICECARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 3448371 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 042146 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0873781 . This is a "PHCS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0873781 . This is a "UNITED" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 06-0873781 . This is a "NORTHEAST HEALTHCARE ALLI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 010042146CT02 . This is a "BLUE CROSS-DARIEN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11208863 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P3170347 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V4895 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 010042146CT01 . This is a "BLUE CROSS-STAMFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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