Provider Demographics
NPI:1871669143
Name:CAETI, DANYELLE L (MD)
Entity Type:Individual
Prefix:
First Name:DANYELLE
Middle Name:L
Last Name:CAETI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-679-6833
Mailing Address - Fax:508-678-2200
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 2001
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-679-6833
Practice Address - Fax:508-678-2200
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT042146208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001421461Medicaid
CT06-0873781OtherCIGNA
CT06-0873781OtherGREAT WEST
CT06-0873781OtherHUMANA CHOICECARE
CT3448371OtherAETNA
CT042146OtherCONNECTICARE
CT06-0873781OtherPHCS
CT06-0873781OtherUNITED
CT06-0873781OtherNORTHEAST HEALTHCARE ALLI
CT010042146CT02OtherBLUE CROSS-DARIEN
CT11208863OtherCAQH
CTP3170347OtherOXFORD
CT2V4895OtherHEALTHNET
CT010042146CT01OtherBLUE CROSS-STAMFORD
CT06-0873781OtherUNITED