Provider Demographics
NPI:1043286297
Name:CABAN, JULIO (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:
Last Name:CABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:NBIMC DEPT OB/GYN
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-7342
Mailing Address - Fax:973-705-8650
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:NBIMC DEPT OB/GYN
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7342
Practice Address - Fax:973-705-8650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA26130207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0317705Medicaid
NJ0317705Medicaid
NJ608256NSVMedicare ID - Type Unspecified