Provider Demographics
NPI:1588940746
Name:CAVALIERE, WILLIAM K (CPHT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:K
Last Name:CAVALIERE
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1345
Mailing Address - Country:US
Mailing Address - Phone:201-444-2754
Mailing Address - Fax:
Practice Address - Street 1:72 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1345
Practice Address - Country:US
Practice Address - Phone:201-444-2754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW01152600183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician