Provider Demographics
NPI:1285819623
Name:CABUNGCAL, BENEDICTO RAMIREZ
Entity Type:Individual
Prefix:MR
First Name:BENEDICTO
Middle Name:RAMIREZ
Last Name:CABUNGCAL
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 1:80 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:PROSPECT PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1828
Mailing Address - Country:US
Mailing Address - Phone:973-790-8696
Mailing Address - Fax:
Practice Address - Street 1:80 N 17TH ST
Practice Address - Street 2:
Practice Address - City:PROSPECT PARK
Practice Address - State:NJ
Practice Address - Zip Code:07508-1828
Practice Address - Country:US
Practice Address - Phone:973-790-8696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08285900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse