Provider Demographics
NPI:1417135435
Name:CACEDA, RICARDO (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:CACEDA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 N COUNTRY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-371-4844
Mailing Address - Fax:
Practice Address - Street 1:46 N COUNTRY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733
Practice Address - Country:US
Practice Address - Phone:631-371-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2885272084P0800X
FLME1076332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry