Provider Demographics
NPI:1437182078
Name:FUERTES, CARIDAD (MD)
Entity Type:Individual
Prefix:MS
First Name:CARIDAD
Middle Name:
Last Name:FUERTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:BASSETT MEDICAL CENTER
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3663
Mailing Address - Fax:607-547-3533
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:BASSETT MEDICAL CENTER
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3663
Practice Address - Fax:607-547-3533
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183414-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F89820Medicare UPIN