Individual
CAITLIN VIRGINIA HACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5959 BIG TREE RD, ORCHARD PARK, NY 14127-2291
(716) 260-1593
Mailing address
2874 KULP RD, EDEN, NY 14057-9411
(716) 479-5491
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022193
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/19/2018
Last updated
11/26/2019
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