Provider Demographics
NPI:1437510724
Name:CAVALIER MEDICAL, PLLC
Entity Type:Organization
Organization Name:CAVALIER MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEFIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVALIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-371-4400
Mailing Address - Street 1:6344 SAUNDERS ST
Mailing Address - Street 2:FIRST FLOOR, LEFT SIDE
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2039
Mailing Address - Country:US
Mailing Address - Phone:718-371-4400
Mailing Address - Fax:718-371-5400
Practice Address - Street 1:6344 SAUNDERS ST
Practice Address - Street 2:FIRST FLOOR, LEFT SIDE
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2039
Practice Address - Country:US
Practice Address - Phone:718-371-4400
Practice Address - Fax:718-371-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2741762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty