Provider Demographics
NPI:1023096732
Name:CACCHIONE, JOSEPH G (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:CACCHIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:J2-3
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-4043
Mailing Address - Fax:216-636-6982
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:J2-3
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-4043
Practice Address - Fax:216-636-6982
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-094699207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012491600004Medicaid
OH3007285Medicaid
PA060012531OtherRR MEDICARE
OHB78190Medicare UPIN