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NPI Code Detail

MEDICARE: MR. EDWIN CABASSA MSN,APRN,BC

MEDICARE:  MR. EDWIN  CABASSA  MSN,APRN,BC
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
1363LF0000XFamily Nurse Practitioner26NN10664700NJ

General Provider Information

NPI Number : 1841225026
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWIN CABASSA MSN,APRN,BC
Provider Business Mailing Address
First Line : 79 MAPLE ST
Second Line :
City : BERGENFIELD
State : NJ
Zip : 07621-1411
Country : US
Telephone Number : 201-501-0564
Fax Number : 201-501-0564
Provider Business Practice Location Address
First Line : 680 BROADWAY
Second Line :
City : PATERSON
State : NJ
Zip : 07514-1422
Country : US
Telephone Number : 973-977-6657
Fax Number : 973-977-6658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ MR. EDWIN CABASSA MSN,APRN,BC” Practice Location

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