Provider Demographics
NPI:1982898789
Name:WILFRED CABAHUG LLC
Entity Type:Organization
Organization Name:WILFRED CABAHUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:CABAHUG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-613-3658
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-0622
Mailing Address - Country:US
Mailing Address - Phone:908-300-3700
Mailing Address - Fax:201-847-0059
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-237-9092
Practice Address - Fax:908-237-9095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06931500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083629Medicare PIN