MEDICARE: MARIA INES CABRERA APN

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	363LA2100X	Acute Care Nurse Practitioner	26NJ01118700	NJ

General Provider Information

NPI Number	:	1700470218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA INES CABRERA APN

Provider Business Mailing Address
First Line	:	1480 PLEASANT VALLEY WAY APT 21
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-1342
Country	:	US
Telephone Number	:	973-731-7039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1480 PLEASANT VALLEY WAY APT 21
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-1342
Country	:	US
Telephone Number	:	941-718-8098
Fax Number	:

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	02/24/2021

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