Provider Demographics
NPI:1609862978
Name:CAIAZZA, MARGARET F (ANP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:F
Last Name:CAIAZZA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 POTTER RD
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1064
Mailing Address - Country:US
Mailing Address - Phone:518-796-0108
Mailing Address - Fax:
Practice Address - Street 1:94 BAY ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3047
Practice Address - Country:US
Practice Address - Phone:518-796-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3034681363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02574385Medicaid
345659OtherMVP
141724932002OtherTRI
P89059Medicare UPIN
NYRB0914Medicare PIN
141724932002OtherTRI
NYRB0914Medicare ID - Type Unspecified