Provider Demographics
NPI:1730147356
Name:CAINE, REBECCA P (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:P
Last Name:CAINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST.
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:413-499-8549
Practice Address - Street 1:777 NORTH ST.
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:413-499-8549
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0139882Medicaid
M20907Medicare PIN
H38731Medicare UPIN
MA0139882Medicaid
A32451Medicare ID - Type Unspecified