Provider Demographics
NPI:1558661363
Name:CABANG, ROSARIO
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:CABANG
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 1:733 NEREID AVE
Mailing Address - Street 2:2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1209
Mailing Address - Country:US
Mailing Address - Phone:718-844-4049
Mailing Address - Fax:
Practice Address - Street 1:733 NEREID AVE
Practice Address - Street 2:2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1209
Practice Address - Country:US
Practice Address - Phone:718-844-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist