Healthcare Provider Details

I. General information

NPI: 1235015801
Provider Name (Legal Business Name): VICTORIA CABAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 NY-59
MONSEY NY
10952
US

IV. Provider business mailing address

77 NY-59
MONSEY NY
10952
US

V. Phone/Fax

Practice location:
  • Phone: 845-356-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number035429-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00942600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: