Provider Demographics
NPI:1659486462
Name:CABAHUG, WILFRED (MD)
Entity Type:Individual
Prefix:
First Name:WILFRED
Middle Name:
Last Name:CABAHUG
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:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858-0029
Mailing Address - Country:US
Mailing Address - Phone:908-237-0403
Mailing Address - Fax:908-237-9095
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-788-6181
Practice Address - Fax:908-237-9095
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06931500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H27398Medicare UPIN
043359Medicare PIN