Provider Demographics
NPI:1598799041
Name:CAVALIERE, GREGG (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:
Last Name:CAVALIERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SAW MILL RIVER RD
Mailing Address - Street 2:STE 206
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1541
Mailing Address - Country:US
Mailing Address - Phone:914-631-7777
Mailing Address - Fax:914-631-0920
Practice Address - Street 1:24 SAW MILL RIVER RD
Practice Address - Street 2:STE 206
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1541
Practice Address - Country:US
Practice Address - Phone:914-631-7777
Practice Address - Fax:914-631-0920
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1532856207X00000X
NY189238207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1532856Medicaid
NYF57602Medicare UPIN
NY1532856Medicaid