Provider Demographics
NPI:1033292586
Name:CAHILL, GERALD W (MDPC)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:W
Last Name:CAHILL
Suffix:
Gender:M
Credentials:MDPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 4TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1331
Mailing Address - Country:US
Mailing Address - Phone:518-483-8990
Mailing Address - Fax:518-481-6049
Practice Address - Street 1:23 4TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1331
Practice Address - Country:US
Practice Address - Phone:518-483-8990
Practice Address - Fax:518-481-6049
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY180867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001059601OtherBCBS
NY01154067Medicaid
E28183Medicare UPIN
NYAA0428Medicare ID - Type Unspecified