Individual
ANTHONY R CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29 SOUTH ST, NEW PROVIDENCE, NJ 07974-2934
(908) 679-8181
(908) 679-8179
Mailing address
29 SOUTH ST, NEW PROVIDENCE, NJ 07974-2934
(908) 679-8181
(908) 679-8179
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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