Provider Demographics
NPI:1699215772
Name:CAFFREY, PATRICIA ANNE
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:CAFFREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3362 ARDMORE RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3404
Mailing Address - Country:US
Mailing Address - Phone:216-280-8338
Mailing Address - Fax:
Practice Address - Street 1:9885 ROCKSIDE RD
Practice Address - Street 2:SUITE 157
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-6273
Practice Address - Country:US
Practice Address - Phone:216-957-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03319093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist