Healthcare Provider Details

I. General information

NPI: 1932627098
Provider Name (Legal Business Name): WILLIAM CABOS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 GRAND ST
JERSEY CITY NJ
07302-4321
US

IV. Provider business mailing address

355 GRAND ST
JERSEY CITY NJ
07302-4321
US

V. Phone/Fax

Practice location:
  • Phone: 201-915-2000
  • Fax:
Mailing address:
  • Phone: 201-915-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: