Provider Demographics
NPI:1124378013
Name:CABEGUIN, ROEL
Entity Type:Individual
Prefix:
First Name:ROEL
Middle Name:
Last Name:CABEGUIN
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 1:36 MUIRFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5150
Mailing Address - Country:US
Mailing Address - Phone:732-407-5670
Mailing Address - Fax:
Practice Address - Street 1:36 MUIRFIELD BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-5150
Practice Address - Country:US
Practice Address - Phone:732-407-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006353A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist