Provider Demographics
NPI:1093474876
Name:CABRAL, DEREK (DPT)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:CABRAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2310
Mailing Address - Country:US
Mailing Address - Phone:978-558-4915
Mailing Address - Fax:
Practice Address - Street 1:166 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2310
Practice Address - Country:US
Practice Address - Phone:978-558-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPTL25869225100000X
NH4944225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist