Provider Demographics
NPI:1700975315
Name:ARVIND R. CAVALE, M.D., L.L.C
Entity Type:Organization
Organization Name:ARVIND R. CAVALE, M.D., L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:RAMACHANDRARAO
Authorized Official - Last Name:CAVALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-953-6804
Mailing Address - Street 1:210 E STREET RD
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7680
Mailing Address - Country:US
Mailing Address - Phone:215-953-6804
Mailing Address - Fax:215-953-6635
Practice Address - Street 1:210 E STREET RD
Practice Address - Street 2:SUITE 3E
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-7680
Practice Address - Country:US
Practice Address - Phone:215-953-6804
Practice Address - Fax:215-953-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052765L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001743400004Medicaid
PA084831Medicare ID - Type Unspecified
PA001743400004Medicaid