Provider Demographics
NPI:1710024468
Name:CABRERA, ELENA A (OTR)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:A
Last Name:CABRERA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-1733
Mailing Address - Country:US
Mailing Address - Phone:201-244-0025
Mailing Address - Fax:
Practice Address - Street 1:237 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-1733
Practice Address - Country:US
Practice Address - Phone:201-244-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTR001061174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist