Provider Demographics
NPI:1932297538
Name:CABBAD, DAVID PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:CABBAD
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 1:94 5TH AVE
Mailing Address - Street 2:MEDICAL OFFICE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3259
Mailing Address - Country:US
Mailing Address - Phone:718-399-9600
Mailing Address - Fax:718-399-9505
Practice Address - Street 1:94 5TH AVE
Practice Address - Street 2:MEDICAL OFFICE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3259
Practice Address - Country:US
Practice Address - Phone:718-399-9600
Practice Address - Fax:718-399-9505
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175992208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01523344Medicaid
NYF73544Medicare UPIN
NY469Z01Medicare ID - Type UnspecifiedMEDICARE