Provider Demographics
NPI:1174837215
Name:CABUSLAY, RAY VICTOR SISTONA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAY VICTOR
Middle Name:SISTONA
Last Name:CABUSLAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2110 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2313
Mailing Address - Country:US
Mailing Address - Phone:860-258-3470
Mailing Address - Fax:860-571-6800
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:SUITE 502
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-545-0549
Practice Address - Fax:860-545-5221
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT051656207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT051656OtherLICENSE
CT51656OtherLICENCE