Provider Demographics
NPI:1326599713
Name:FOLEY, CAITLIN NICOLE (PA)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:NICOLE
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:NICOLE
Other - Last Name:HAENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX MED
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-2521
Mailing Address - Fax:585-756-4411
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642
Practice Address - Country:US
Practice Address - Phone:585-275-2726
Practice Address - Fax:585-276-1992
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22047207RC0200X
NY022047363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine