Provider Demographics
NPI:1497997134
Name:CAVALIER, EVELYN G (DPM)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:G
Last Name:CAVALIER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6456 DIETERLE CRES
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5027
Mailing Address - Country:US
Mailing Address - Phone:718-371-4400
Mailing Address - Fax:718-371-5400
Practice Address - Street 1:6344 SAUNDERS ST STE 1
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2044
Practice Address - Country:US
Practice Address - Phone:718-371-4400
Practice Address - Fax:718-371-5400
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00299800213E00000X
NYN006350213E00000X
FLPO4279213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03206695Medicaid
NYG300014253Medicare PIN