Provider Demographics
NPI:1316285083
Name:CABA, DAVID (CASAC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:CABA
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E MOSHOLU PKWY S
Mailing Address - Street 2:2H
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1713
Mailing Address - Country:US
Mailing Address - Phone:718-314-1452
Mailing Address - Fax:
Practice Address - Street 1:481 MAIN ST
Practice Address - Street 2:403
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6324
Practice Address - Country:US
Practice Address - Phone:718-314-1452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20979101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)