MEDICARE: DR. JOSEPH CABRERA DPM

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	213E00000X	Podiatrist	005814	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	149882	OTHER	NJ	HIGHMARK MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861475972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH CABRERA DPM

Provider Business Mailing Address
First Line	:	401 FOREST AVE
Second Line	:
City	:	GLEN RIDGE
State	:	NJ
Zip	:	07028-1927
Country	:	US
Telephone Number	:	718-981-0100
Fax Number	:	718-351-3215

Provider Business Practice Location Address
First Line	:	2338 RICHMOND RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2346
Country	:	US
Telephone Number	:	718-981-0100
Fax Number	:	718-351-3215

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	01/12/2015

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