MEDICARE: CAVALIER MEDICAL, PLLC

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	2084N0400X	Neurology Physician	274176	NY

General Provider Information

NPI Number	:	1437510724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAVALIER MEDICAL, PLLC

Provider Business Mailing Address
First Line	:	6344 SAUNDERS ST
Second Line	:	FIRST FLOOR, LEFT SIDE
City	:	REGO PARK
State	:	NY
Zip	:	11374-2039
Country	:	US
Telephone Number	:	718-371-4400
Fax Number	:	718-371-5400

Provider Business Practice Location Address
First Line	:	6344 SAUNDERS ST
Second Line	:	FIRST FLOOR, LEFT SIDE
City	:	REGO PARK
State	:	NY
Zip	:	11374-2039
Country	:	US
Telephone Number	:	718-371-4400
Fax Number	:	718-371-5400

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YEFIM CAVALIER
Credential	:	D.O.
Telephone Number	:	718-371-4400

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	03/14/2016

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