Provider Demographics
NPI:1699278754
Name:CABRERA-ROBLEDO, KRISTIE LEE
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LEE
Last Name:CABRERA-ROBLEDO
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 1:343 63RD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4434
Mailing Address - Country:US
Mailing Address - Phone:347-488-8589
Mailing Address - Fax:
Practice Address - Street 1:1201 66TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5914
Practice Address - Country:US
Practice Address - Phone:718-259-4389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022283225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist