Provider Demographics
NPI:1912262858
Name:CABRAL, STEVEN J
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:CABRAL
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 1:160 FREMONT ST
Mailing Address - Street 2:UNIT 404
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2371
Mailing Address - Country:US
Mailing Address - Phone:774-218-5618
Mailing Address - Fax:
Practice Address - Street 1:157 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2765
Practice Address - Country:US
Practice Address - Phone:978-562-5096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist