Provider Demographics
NPI:1851508071
Name:CABANAS, RAMON MAXIMILIAN (MD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:MAXIMILIAN
Last Name:CABANAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 YORK AVE
Mailing Address - Street 2:SUITE 33F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7892
Mailing Address - Country:US
Mailing Address - Phone:212-289-0745
Mailing Address - Fax:718-524-5510
Practice Address - Street 1:699 92 STR
Practice Address - Street 2:VICTORY MEMORIAL HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3625
Practice Address - Country:US
Practice Address - Phone:718-567-1229
Practice Address - Fax:718-567-1508
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145376208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00652355Medicaid
NY48A242Medicare ID - Type Unspecified
NY00652355Medicaid