Provider Demographics
NPI:1659050557
Name:CABRERA, DIANE ROSA
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:ROSA
Last Name:CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SPOFFORD AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474-6511
Mailing Address - Country:US
Mailing Address - Phone:929-336-4750
Mailing Address - Fax:
Practice Address - Street 1:1290 SPOFFORD AVE FL 4
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-6511
Practice Address - Country:US
Practice Address - Phone:929-336-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist