Provider Demographics
NPI:1891996138
Name:LANCE F. CAFFIERO DPM PA
Entity Type:Organization
Organization Name:LANCE F. CAFFIERO DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-262-1171
Mailing Address - Street 1:4000 MITCHELLVILLE RD STE A400
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3137
Mailing Address - Country:US
Mailing Address - Phone:301-262-1171
Mailing Address - Fax:301-262-7483
Practice Address - Street 1:4000 MITCHELLVILLE RD STE A400
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3137
Practice Address - Country:US
Practice Address - Phone:301-262-1171
Practice Address - Fax:301-262-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01299213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD480035249OtherRAIL ROAD MEDICARE
MD309802800Medicaid
MD00B542L06Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.
MDG01106Medicare ID - Type UnspecifiedMEDICARE GROUP NO.
MD480035249OtherRAIL ROAD MEDICARE
MD555502700Medicaid