MEDICARE: DARLENE MARIE CABRERA LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	227444	NY

General Provider Information

NPI Number	:	1336298371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARLENE MARIE CABRERA LPN

Provider Business Mailing Address
First Line	:	1699 EAST AVE
Second Line	:	PO BOX 16
City	:	BARKER
State	:	NY
Zip	:	14012
Country	:	US
Telephone Number	:	716-380-8738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1699 EAST AVE
Second Line	:
City	:	BARKER
State	:	NY
Zip	:	14012
Country	:	US
Telephone Number	:	716-380-8738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	10/02/2008

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