Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 205-305 | NY |
NPI | 1447398508 |
---|---|
Provider Name | Orsuville Guiang Cabatu |
First Address | Union City, NJ 07087-6514 |
Second Address | Newburgh, NY 12550-2992 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02212499 | (05) | NY |
G57172 | (02) | NY |