Healthcare Provider Details

I. General information

NPI: 1083364582
Provider Name (Legal Business Name): DANIEL ENRIQUE CABRERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 3RD AVE
NEW YORK NY
10035-2231
US

IV. Provider business mailing address

2265 3RD AVE
NEW YORK NY
10035-2231
US

V. Phone/Fax

Practice location:
  • Phone: 212-289-6650
  • Fax:
Mailing address:
  • Phone: 212-289-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number339632-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number339632-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: