Provider Demographics
NPI:1609967934
Name:CAPE GERIATRICS
Entity Type:Organization
Organization Name:CAPE GERIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:V
Authorized Official - Last Name:GEAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-295-4450
Mailing Address - Street 1:194 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-2112
Mailing Address - Country:US
Mailing Address - Phone:508-295-4450
Mailing Address - Fax:
Practice Address - Street 1:194 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2112
Practice Address - Country:US
Practice Address - Phone:508-295-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9760709Medicaid
MAM15025OtherBLUE CROSS BLUE SHIELD
MA735837OtherTUFTS HEALTH PLAN
MAM15025Medicare ID - Type Unspecified