Provider Demographics
NPI:1265173009
Name:CARAVELLA, JOSEPH ELLIS
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ELLIS
Last Name:CARAVELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6343 CEDAR CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-9636
Mailing Address - Country:US
Mailing Address - Phone:504-343-2675
Mailing Address - Fax:
Practice Address - Street 1:3170 WEST ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1712
Practice Address - Country:US
Practice Address - Phone:585-396-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335981207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine