Provider Demographics
NPI:1508568213
Name:CABA, YAHAIRA
Entity Type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:
Last Name:CABA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FISHER AVENUE
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2614
Mailing Address - Country:US
Mailing Address - Phone:917-449-4149
Mailing Address - Fax:
Practice Address - Street 1:110 FISHER AVE
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2614
Practice Address - Country:US
Practice Address - Phone:917-449-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2024-01-18
Deactivation Date:2023-12-14
Deactivation Code:
Reactivation Date:2023-12-26
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No174400000XOther Service ProvidersSpecialist