Provider Demographics
NPI:1518187335
Name:GERALD W. CAHILL MDPC
Entity type:Organization
Organization Name:GERALD W. CAHILL MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-483-8962
Mailing Address - Street 1:23 4TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1331
Mailing Address - Country:US
Mailing Address - Phone:518-483-8962
Mailing Address - Fax:518-481-6049
Practice Address - Street 1:23 4TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1331
Practice Address - Country:US
Practice Address - Phone:518-483-8962
Practice Address - Fax:518-481-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180867174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01154067Medicaid
NYAA0428Medicare ID - Type Unspecified
NYE28183Medicare UPIN