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NPI Code Detail

MEDICARE: MIDLAND MEDICAL ASSOCIATES, LLC

MEDICARE: MIDLAND MEDICAL ASSOCIATES, LLC
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
1170100000XPh.D. Medical Genetics25MA05783300NJ

General Provider Information

NPI Number : 1619046018
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDLAND MEDICAL ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 2726 KENNEDY BOULEVARD
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07306-5508
Country : US
Telephone Number : 201-333-4115
Fax Number : 201-333-6224
Provider Business Practice Location Address
First Line : 2726 KENNEDY BOULEVARD
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07306-5508
Country : US
Telephone Number : 201-333-4115
Fax Number : 201-333-6224
Authorized Official
Title or Position : PHYSICIAN
Name : DR. VICTOR LEE CABALES
Credential : M.D.
Telephone Number : 201-333-4115
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/14/2010

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Directions to “MIDLAND MEDICAL ASSOCIATES, LLC ” Practice Location

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