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General NPI Number Information
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NPI Number | 1033920434
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Entity Type | Individual
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Provider Name | AURELIO SOLIVEN CABAONG JR.
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Gender | Male
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 119 W 124TH ST
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City | NEW YORK
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State | NY
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Zip | 10027-4920
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Country | US
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Telephone | 212-932-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 6209 KENNEDY BLVD E
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-4043
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 344092
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License Number State | NY
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