Provider Demographics
NPI:1710497466
Name:CAUTIOUS CARE MEDICAL, P.C.
Entity Type:Organization
Organization Name:CAUTIOUS CARE MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLARISSE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLEMONS FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-436-3701
Mailing Address - Street 1:3250 WESTCHESTER AVE RM 101
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4548
Mailing Address - Country:US
Mailing Address - Phone:899-436-3701
Mailing Address - Fax:516-490-7011
Practice Address - Street 1:3250 WESTCHESTER AVE RM 101
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4548
Practice Address - Country:US
Practice Address - Phone:899-436-3701
Practice Address - Fax:516-490-7011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150089208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty