Healthcare Provider Details

I. General information

NPI: 1487851697
Provider Name (Legal Business Name): CLARA CABRERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MONTVALE AVE SUITE 3
STONEHAM MA
02180
US

IV. Provider business mailing address

PO BOX 760
WINCHESTER MA
01890-4260
US

V. Phone/Fax

Practice location:
  • Phone: 781-481-9255
  • Fax: 781-481-9257
Mailing address:
  • Phone: 781-756-7273
  • Fax: 781-756-7274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number231842
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: