Provider Demographics
NPI:1881619302
Name:D'AMBRA-CABRY, KIMBERLY A (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:D'AMBRA-CABRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MARTER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3124
Mailing Address - Country:US
Mailing Address - Phone:856-235-6565
Mailing Address - Fax:856-235-6566
Practice Address - Street 1:110 MARTER AVE STE 102
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-235-6565
Practice Address - Fax:856-235-6566
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA65773207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA954633Medicare ID - Type Unspecified
G53109Medicare UPIN