Provider Demographics
NPI:1215401641
Name:BARBARA A CAVALLARO, MD PC
Entity Type:Organization
Organization Name:BARBARA A CAVALLARO, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-688-0823
Mailing Address - Street 1:PO BOX 1140
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-8140
Mailing Address - Country:US
Mailing Address - Phone:201-688-0823
Mailing Address - Fax:845-544-2201
Practice Address - Street 1:211 ESSEX ST STE 402
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3246
Practice Address - Country:US
Practice Address - Phone:201-301-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1821058629OtherINDIVIDUAL NPI
10697325OtherCAQH