Provider Demographics
NPI:1235451790
Name:ROMEO A CABALLES JR MD PA
Entity Type:Organization
Organization Name:ROMEO A CABALLES JR MD PA
Other - Org Name:BRANCHBURG INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CABALLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:908-203-0022
Mailing Address - Street 1:26 OLD SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08802-1210
Mailing Address - Country:US
Mailing Address - Phone:908-203-0022
Mailing Address - Fax:
Practice Address - Street 1:9 LAMINGTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3374
Practice Address - Country:US
Practice Address - Phone:908-203-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07101700261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8289301Medicaid
H24984Medicare UPIN