Provider Demographics
NPI:1639125610
Name:CABRAL, CESAR SR (MD)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:
Last Name:CABRAL
Suffix:SR
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 1:449 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-5105
Mailing Address - Country:US
Mailing Address - Phone:201-823-2334
Mailing Address - Fax:201-823-2344
Practice Address - Street 1:297 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2910
Practice Address - Country:US
Practice Address - Phone:201-795-0606
Practice Address - Fax:201-795-0606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0332210207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1483404Medicaid
NJCA452131Medicare ID - Type Unspecified
NJC55293Medicare UPIN