Provider Demographics
NPI:1407847007
Name:LAFFERTY, CAITLIN MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:MARIE
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 WALDEN AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043
Mailing Address - Country:US
Mailing Address - Phone:716-668-7051
Mailing Address - Fax:716-668-7069
Practice Address - Street 1:3332 WALDEN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043
Practice Address - Country:US
Practice Address - Phone:716-668-7051
Practice Address - Fax:716-668-7069
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4207541207V00000X
NYF305204-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology