Provider Demographics
NPI:1295724268
Name:CAIAFA, RICHARD P SR (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:CAIAFA
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08562-1625
Mailing Address - Country:US
Mailing Address - Phone:609-758-3492
Mailing Address - Fax:609-758-3492
Practice Address - Street 1:238 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:WRIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08562-1625
Practice Address - Country:US
Practice Address - Phone:609-758-3492
Practice Address - Fax:609-758-3492
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2016-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00158400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1187007Medicaid
NJT45137Medicare UPIN
NJCA450491Medicare ID - Type UnspecifiedPROVIDER #