Provider Demographics
NPI:1861466542
Name:CADY, CHARLES HENRY (AT,C)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:HENRY
Last Name:CADY
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 EATON RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-2412
Mailing Address - Country:US
Mailing Address - Phone:315-691-2448
Mailing Address - Fax:
Practice Address - Street 1:7450 EATON RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-2412
Practice Address - Country:US
Practice Address - Phone:315-691-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000199174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist