MEDICARE: MR. PIO J CABADA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	079594	NY
2	1041C0700X	Clinical Social Worker	082055	NY

General Provider Information

NPI Number	:	1255645651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PIO J CABADA LCSW

Provider Business Mailing Address
First Line	:	245 E 93RD ST APT 9J
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-3965
Country	:	US
Telephone Number	:	917-733-5499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 2ND AVE STE AZ-5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-5363
Country	:	US
Telephone Number	:	917-733-5499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	09/03/2020

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