Individual
MR. JOSEPH K CAVALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 ROUTE 112 BLDG 6, PORT JEFFERSON STATION, NY 11776-8054
(631) 732-9090
(631) 732-8235
Mailing address
1500 ROUTE 112, BLDG 6, PORT JEFF STA, NY 11776-8054
(631) 732-9090
(631) 732-8235
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
158971
NY
Other
Enumeration date
08/17/2006
Last updated
02/01/2012
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