Provider Demographics
NPI:1801933023
Name:PAULIN, CESAR MABANAG (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:MABANAG
Last Name:PAULIN
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 1:1000 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2521
Mailing Address - Country:US
Mailing Address - Phone:732-431-1880
Mailing Address - Fax:732-866-4268
Practice Address - Street 1:1000 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2521
Practice Address - Country:US
Practice Address - Phone:732-431-1880
Practice Address - Fax:732-866-4268
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02469500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1963201Medicaid
NJ033543Medicare ID - Type Unspecified
NJ1963201Medicaid