Provider Demographics
NPI:1841092251
Name:CADAVID, JUAN M
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:M
Last Name:CADAVID
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 W CHURCH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1727
Mailing Address - Country:US
Mailing Address - Phone:917-907-1753
Mailing Address - Fax:
Practice Address - Street 1:125 PATERSON STREET
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-235-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program