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General NPI Number Information
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NPI Number | 1760526164
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Entity Type | Individual
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Provider Name | JOSE C. CABASSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 205 E 111TH ST
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City | NEW YORK
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State | NY
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Zip | 10029-2901
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Country | US
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Telephone | 646-864-0213
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Fax | 646-864-0237
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Provider Business Mailing Address
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Address Line | 269 MADISON RD
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City | SCARSDALE
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State | NY
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Zip | 10583-6445
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Country | US
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Telephone | 267-304-6165
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 262225
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License Number State | NY
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