1851508071 NPI number — RAMON MAXIMILIAN CABANAS MD

Table of content: RAMON MAXIMILIAN CABANAS MD (NPI 1851508071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851508071 NPI number — RAMON MAXIMILIAN CABANAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CABANAS
Provider First Name:
RAMON
Provider Middle Name:
MAXIMILIAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851508071
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1725 YORK AVE
Provider Second Line Business Mailing Address:
SUITE 33F
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10128-7892
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-289-0745
Provider Business Mailing Address Fax Number:
718-524-5510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
699 92 STR
Provider Second Line Business Practice Location Address:
VICTORY MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11228-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-567-1229
Provider Business Practice Location Address Fax Number:
718-567-1508
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  145376 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00652355 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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