Provider Demographics
NPI:1518554088
Name:CABRERA MARTE, NAIROVI D
Entity Type:Individual
Prefix:
First Name:NAIROVI
Middle Name:D
Last Name:CABRERA MARTE
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 1:14 E MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-4124
Mailing Address - Country:US
Mailing Address - Phone:201-628-6493
Mailing Address - Fax:
Practice Address - Street 1:14 E MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-4124
Practice Address - Country:US
Practice Address - Phone:201-628-6493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-24-70615103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst