Provider Demographics
NPI:1164017620
Name:CABRALES, GABRIEL AUSTIN (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:AUSTIN
Last Name:CABRALES
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NEILL AVE APT 16B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-3028
Mailing Address - Country:US
Mailing Address - Phone:914-312-5941
Mailing Address - Fax:
Practice Address - Street 1:1640 BRONXDALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3302
Practice Address - Country:US
Practice Address - Phone:718-409-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty