Provider Demographics
NPI:1063596179
Name:CAVALIERE, AVA A (DO)
Entity type:Individual
Prefix:DR
First Name:AVA
Middle Name:A
Last Name:CAVALIERE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:08230-0617
Mailing Address - Country:US
Mailing Address - Phone:609-624-9003
Mailing Address - Fax:609-624-9002
Practice Address - Street 1:2041 N ROUTE 9
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1162
Practice Address - Country:US
Practice Address - Phone:609-652-1000
Practice Address - Fax:609-441-8976
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB07105500208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8773505Medicaid
NY02362476Medicaid
MD7954000Medicaid
H78492Medicare UPIN
NY02362476Medicaid