Provider Demographics
NPI:1154499358
Name:CAFFERTY, MAUREEN SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:SARAH
Last Name:CAFFERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:SARAH
Other - Last Name:CAFFERTY MCALLISTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1111 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1716
Mailing Address - Country:US
Mailing Address - Phone:212-523-4490
Mailing Address - Fax:212-523-1723
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-6770
Practice Address - Fax:212-523-3431
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1424622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00886379Medicaid
NY00886379Medicaid
33D821Medicare ID - Type Unspecified