Provider Demographics
NPI:1912890385
Name:CABRERA, PEDRO L
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:L
Last Name:CABRERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 E 148TH ST APT 305
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-4163
Mailing Address - Country:US
Mailing Address - Phone:347-313-0938
Mailing Address - Fax:
Practice Address - Street 1:455 E 148TH ST APT 305
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4163
Practice Address - Country:US
Practice Address - Phone:347-313-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5633868344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi