1033292586 NPI number — MR. GERALD W CAHILL MDPC

Table of content: MR. GERALD W CAHILL MDPC (NPI 1033292586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033292586 NPI number — MR. GERALD W CAHILL MDPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAHILL
Provider First Name:
GERALD
Provider Middle Name:
W
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MDPC
Provider Gender Code:
M

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:
1033292586
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 4TH ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
MALONE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12953-1331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-483-8990
Provider Business Mailing Address Fax Number:
518-481-6049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 4TH ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
MALONE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12953-1331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-483-8990
Provider Business Practice Location Address Fax Number:
518-481-6049
Provider Enumeration Date:
10/20/2006

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: 207Q00000X , with the licence number:  180867 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001059601 . This is a "BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01154067 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com