Provider Demographics
NPI:1235205162
Name:MCCAULEY, PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RIDGE PLAZA
Mailing Address - Street 2:SIUTE 105
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-253-8142
Mailing Address - Fax:914-253-8352
Practice Address - Street 1:10 RYE RIDGE PLZ
Practice Address - Street 2:SUITE 105
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2828
Practice Address - Country:US
Practice Address - Phone:914-253-8142
Practice Address - Fax:914-253-8352
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041555-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice