Provider Demographics
NPI:1700470218
Name:CABRERA, MARIA INES (APN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:INES
Last Name:CABRERA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 PLEASANT VALLEY WAY APT 21
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1342
Mailing Address - Country:US
Mailing Address - Phone:973-731-7039
Mailing Address - Fax:
Practice Address - Street 1:1480 PLEASANT VALLEY WAY APT 21
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1342
Practice Address - Country:US
Practice Address - Phone:941-718-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01118700363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty