Provider Demographics
NPI:1437106135
Name:CABRERA, SHIRLEY (PT)
Entity Type:Individual
Prefix:MISS
First Name:SHIRLEY
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:MOUNASRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:28 ENNIS DR
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1108
Mailing Address - Country:US
Mailing Address - Phone:732-470-2627
Mailing Address - Fax:
Practice Address - Street 1:28 ENNIS DR
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1108
Practice Address - Country:US
Practice Address - Phone:732-470-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01086600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist