Individual
ANTHONY R CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25MA07124300
NJ
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
25MA07124300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203343
—
NJ
01
—
04-29599
EVERCARE
—
01
—
5221142040
BCBS OF NJ
—
Enumeration date
03/27/2007
Last updated
07/07/2020
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