Provider Demographics
NPI:1740854900
Name:CAULEY, CRAIG ANDREW (CPHT)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:ANDREW
Last Name:CAULEY
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 GRAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2431
Mailing Address - Country:US
Mailing Address - Phone:716-804-1073
Mailing Address - Fax:716-751-1433
Practice Address - Street 1:PINE PHARMACY
Practice Address - Street 2:1806 PINE AVE
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301
Practice Address - Country:US
Practice Address - Phone:716-285-0340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10062659183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician