MEDICARE: MAUREEN CABAN RN, C-ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	F301609-1	NY

General Provider Information

NPI Number	:	1013163815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN CABAN RN, C-ANP

Provider Business Mailing Address
First Line	:	55 5TH AVE
Second Line	:	12TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-4301
Country	:	US
Telephone Number	:	212-463-8733
Fax Number	:	212-633-9388

Provider Business Practice Location Address
First Line	:	55 5TH AVE
Second Line	:	12TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-4301
Country	:	US
Telephone Number	:	212-463-8733
Fax Number	:	212-633-9388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	08/12/2008

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