Provider Demographics
NPI:1144535865
Name:CACIQUE COMMUNITY CORPORATION
Entity type:Organization
Organization Name:CACIQUE COMMUNITY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:PAULINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-284-5608
Mailing Address - Street 1:85 POST AVE APT 52
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-4727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 POST AVE APT 52
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-4727
Practice Address - Country:US
Practice Address - Phone:917-284-5608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare