Provider Demographics
NPI:1942236260
Name:CAIN, PATRICK JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:CAIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 902
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0003
Mailing Address - Country:US
Mailing Address - Phone:917-620-2894
Mailing Address - Fax:
Practice Address - Street 1:641 BROADWAY
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1926
Practice Address - Country:US
Practice Address - Phone:917-620-2894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MDOO284800213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist