Provider Demographics
NPI:1659608057
Name:CARACCI, JAMES R (NP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:CARACCI
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:PO BOX 347332
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-4332
Mailing Address - Country:US
Mailing Address - Phone:518-348-1276
Mailing Address - Fax:518-348-1279
Practice Address - Street 1:211 CHURCH
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1003
Practice Address - Country:US
Practice Address - Phone:518-583-8343
Practice Address - Fax:518-583-8386
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2013-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY306024363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03474251Medicaid