Individual
NICHOLAS CACCAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CLINTON ST, SUITE 20, BROOKLYN, NY 11201-4362
(718) 625-8700
(718) 625-7536
Mailing address
100 CLINTON ST, SUITE 20, BROOKLYN, NY 11201
(718) 643-6005
(718) 625-7563
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
126427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01591937
—
NY
Enumeration date
09/11/2006
Last updated
11/22/2011
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