Provider Demographics
NPI:1093888463
Name:PAUL J CARO MD
Entity Type:Organization
Organization Name:PAUL J CARO MD
Other - Org Name:CARO MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR CARO MEDICAL CENTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NACCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-947-9147
Mailing Address - Street 1:7008 ERIE RD RTE 5
Mailing Address - Street 2:SUITE A
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047
Mailing Address - Country:US
Mailing Address - Phone:716-947-9147
Mailing Address - Fax:716-947-5175
Practice Address - Street 1:7008 ERIE RD RTE 5
Practice Address - Street 2:SUITE A
Practice Address - City:DERBY
Practice Address - State:NY
Practice Address - Zip Code:14047
Practice Address - Country:US
Practice Address - Phone:716-947-9147
Practice Address - Fax:716-947-5175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0516Medicare ID - Type Unspecified