Provider Demographics
NPI:1497738157
Name:CAVALIERE, RAYMOND (DPM)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:CAVALIERE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 28TH ST
Mailing Address - Street 2:STE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8538
Mailing Address - Country:US
Mailing Address - Phone:212-481-0064
Mailing Address - Fax:212-481-0148
Practice Address - Street 1:201 E 28TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8538
Practice Address - Country:US
Practice Address - Phone:212-481-0064
Practice Address - Fax:212-481-0148
Is Sole Proprietor?:No
Enumeration Date:2005-11-26
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003397-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00944445Medicaid
NYT51294Medicare UPIN
NY00944445Medicaid
NY5104700001Medicare NSC