Basic Information
| Provider Information | |||||||||
| NPI: | 1023108826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALD-CAGAN | ||||||||
| FirstName: | PAULETTE | ||||||||
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| Credential: | RNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 58 ELM RD | ||||||||
| Address2: | |||||||||
| City: | BRIARCLIFF MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105102224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189206722 | ||||||||
| FaxNumber: | 7186559672 | ||||||||
| Practice Location | |||||||||
| Address1: | MMC - DEPARTMENT OF MEDICINE | ||||||||
| Address2: | 111 EAST 210TH STREET | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189206722 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | F330313 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.