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General NPI Number Information
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NPI Number | 1497854236
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Entity Type | Individual
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Provider Name | JOSE M CHAVEZ-CACHO M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 61 PASSAIC AVENUE
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City | PASSAIC
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State | NJ
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Zip | 07055
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Country | US
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Telephone | 973-473-5053
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Fax | 973-574-9430
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Provider Business Mailing Address
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Address Line | 61 PASSAIC AVENUE
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City | PASSAIC
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State | NJ
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Zip | 07055
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Country | US
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Telephone | 973-473-5053
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Fax | 973-574-9430
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA058212
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 25MA058212
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License Number State | NJ
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