Provider Demographics
NPI:1518563188
Name:CABRERA, FATIMA ANDREA
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:ANDREA
Last Name:CABRERA
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 1:296 HEATHCOTE RD
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-1742
Mailing Address - Country:US
Mailing Address - Phone:347-837-4130
Mailing Address - Fax:
Practice Address - Street 1:5913 GROVE ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2647
Practice Address - Country:US
Practice Address - Phone:646-456-0819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program