Provider Demographics
NPI:1932476744
Name:CAULEY, LISA ANN
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:CAULEY
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 1:5301 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1625
Mailing Address - Country:US
Mailing Address - Phone:716-646-3375
Mailing Address - Fax:
Practice Address - Street 1:5301 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1625
Practice Address - Country:US
Practice Address - Phone:716-646-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist