Provider Demographics
NPI:1770696759
Name:CAULFIELD, BARBARA A (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:CAULFIELD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SENECA POINT RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8976
Mailing Address - Country:US
Mailing Address - Phone:585-393-9855
Mailing Address - Fax:
Practice Address - Street 1:3019 COUNTY COMPLEX DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9505
Practice Address - Country:US
Practice Address - Phone:585-396-4363
Practice Address - Fax:585-396-4993
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330842363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3109089OtherVALUE OPTIONS
NYEMOtherEXCELLUS
NY014003729OtherEXCELLUS
NY103283EUOtherPREFERRED CARE
NY0330F330842Medicaid
NY014003729OtherEXCELLUS
NYBB4076Medicare ID - Type UnspecifiedUPSTATE MEDICARE