Provider Demographics
NPI:1447398508
Name:CABATU, ORSUVILLE GUIANG (MD)
Entity Type:Individual
Prefix:
First Name:ORSUVILLE
Middle Name:GUIANG
Last Name:CABATU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6514
Mailing Address - Country:US
Mailing Address - Phone:201-583-0551
Mailing Address - Fax:201-583-0551
Practice Address - Street 1:1418 ROUTE 300
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-2992
Practice Address - Country:US
Practice Address - Phone:845-566-4202
Practice Address - Fax:845-566-4238
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205-305204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02212499Medicaid
NYG57172Medicare UPIN
NY02212499Medicaid