Provider Demographics
NPI:1306893367
Name:CABEZON, MICHAEL JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:CABEZON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 681 - VEN BRUNT STATION
Mailing Address - Street 2:PARK SLOPE EMERGENCY PHYSICIAN SERVICES PC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-317-6280
Practice Address - Street 1:506 SIXTH STREET
Practice Address - Street 2:THE METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-780-3159
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2024-03-18
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Provider Licenses
StateLicense IDTaxonomies
NY206964207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01749820Medicaid
NY01749820Medicaid
F59541Medicare UPIN