Provider Demographics
NPI:1265691927
Name:CABALONA, WILHELMINA (MD)
Entity type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:
Last Name:CABALONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-742-8787
Mailing Address - Fax:603-433-4939
Practice Address - Street 1:121 CORPORATE DRIVE
Practice Address - Street 2:BUILDING C
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-742-8787
Practice Address - Fax:603-610-8088
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15942207RH0000X
NH16629207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP01381746OtherRAILROAD MEDICARE
NH3098166Medicaid
NHP01381746OtherRAILROAD MEDICARE