Provider Demographics
NPI:1437482080
Name:CABRERA, ALEXANDRA (LPN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8707 35TH AVE
Mailing Address - Street 2:#6E
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5643
Mailing Address - Country:US
Mailing Address - Phone:917-698-0737
Mailing Address - Fax:
Practice Address - Street 1:225 VANDALIA AVE
Practice Address - Street 2:#2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-1421
Practice Address - Country:US
Practice Address - Phone:718-642-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288535-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse