Active NPI
Paul Cavanagh, PHD
- Social Worker
- Rockville Centre, NY
National Provider Identifier
1669299392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 124531-01
- Practice address
- 53 N Park Ave Ste 203
Rockville Centre, NY 11570-4160 - Phone
- (631) 371-3825
- NPI assigned
- Sep 24, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 124531-01 | NY | Primary |
Addresses
Primary practice location
53 N Park Ave Ste 203
Rockville Centre, NY 11570-4160
Mailing address
73 Elliott PL
Freeport, NY 11520-4812
Phone (516) 761-9959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124531-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1669299392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 ELLIOTT PL",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115204812",
"telephone_number": "516-761-9959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 N PARK AVE STE 203",
"city": "ROCKVILLE CENTRE",
"state": "NY",
"postal_code": "115704160",
"telephone_number": "631-371-3825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAGH",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "124531-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville Centre, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.