Provider Demographics
NPI:1942355862
Name:MCCAULEY, SIDNEY J (DC)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:J
Last Name:MCCAULEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 SOUTH BENSON ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824
Mailing Address - Country:US
Mailing Address - Phone:203-255-0080
Mailing Address - Fax:203-255-0018
Practice Address - Street 1:79 SOUTH BENSON ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824
Practice Address - Country:US
Practice Address - Phone:203-255-0080
Practice Address - Fax:203-255-0018
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor