Provider Demographics
NPI:1144283540
Name:CAYEA, JAMES GEORGE (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GEORGE
Last Name:CAYEA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1745
Mailing Address - Country:US
Mailing Address - Phone:845-758-8818
Mailing Address - Fax:845-758-9215
Practice Address - Street 1:7381 S BROADWAY
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1745
Practice Address - Country:US
Practice Address - Phone:845-758-8818
Practice Address - Fax:845-758-9215
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003535T152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC26381OtherBC/BS
NY903534OtherBLOCK
NY950427OtherMVP
NY10032271OtherCDPHP
NY903535OtherBLOCK
NYVUT003535OtherLICENSE NUMBER
NYC26381OtherBC/BS
NY10032271OtherCDPHP
NY0244570002Medicare NSC