Provider Demographics
NPI:1982023057
Name:FERNANDEZ-CABRERA, GABRIELLE
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:FERNANDEZ-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 1:5512 111TH ST
Mailing Address - Street 2:2C
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4035
Mailing Address - Country:US
Mailing Address - Phone:347-822-7114
Mailing Address - Fax:
Practice Address - Street 1:5512 111TH ST
Practice Address - Street 2:2C
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-4035
Practice Address - Country:US
Practice Address - Phone:347-822-7114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist