Provider Demographics
NPI:1609854710
Name:CABREDO, QUIRICO CECILIO (MD)
Entity Type:Individual
Prefix:DR
First Name:QUIRICO
Middle Name:CECILIO
Last Name:CABREDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:212 COAST GUARD DR
Mailing Address - Street 2:RM-D113
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-5005
Mailing Address - Country:US
Mailing Address - Phone:718-354-4414
Mailing Address - Fax:718-354-4415
Practice Address - Street 1:212 COAST GUARD DR
Practice Address - Street 2:RM-D113
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-5005
Practice Address - Country:US
Practice Address - Phone:718-354-4414
Practice Address - Fax:718-354-4415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101050128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine