Provider Demographics
NPI:1215516026
Name:CABRERA, DAMIAN LOUIS (MT-BC)
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:LOUIS
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1404
Mailing Address - Country:US
Mailing Address - Phone:347-788-9049
Mailing Address - Fax:
Practice Address - Street 1:4967 WILLIAM FLYNN HWY # 6
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8405
Practice Address - Country:US
Practice Address - Phone:347-788-9049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16103225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty