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Vincent Paul Canabal

Emergency Medicine

Allopathic & Osteopathic Physicians

46 New St, Belleville, NJ 07109-2006

PECOS Enrollment

This provider is enrolled in PECOS as VINCENT CANABAL.

Based on the most recent information from CMS, provider Vincent Paul Canabal is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1194912295
Provider Type
Individual
Full Name
Canabal, Vincent Paul
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
10/2/2007
Last Updated
7/20/2009

Contact Information

Practice Location

46 New St, Belleville, NJ 07109-2006

(973) 450-9821

Unlisted Fax

Mailing Location

46 New St, Belleville, NJ 07109-2006

(973) 450-9821

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 23MA08596700 New Jersey

Vincent Paul Canabal

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Ahn, Joanne

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Kansagra, Nilesh V

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