Provider Demographics
NPI:1508906009
Name:CACES, WILFREDO V (MD)
Entity Type:Individual
Prefix:
First Name:WILFREDO
Middle Name:V
Last Name:CACES
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 1:1 ADRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1452
Mailing Address - Country:US
Mailing Address - Phone:718-579-7693
Mailing Address - Fax:718-538-3252
Practice Address - Street 1:1309 FULTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2403
Practice Address - Country:US
Practice Address - Phone:718-579-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156418207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease