Provider Demographics
NPI:1871049213
Name:ROJAS CABRERA, LUIS ARISTIDES (SA-C)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ARISTIDES
Last Name:ROJAS CABRERA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1714
Mailing Address - Country:US
Mailing Address - Phone:917-608-5207
Mailing Address - Fax:877-515-8647
Practice Address - Street 1:457 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1714
Practice Address - Country:US
Practice Address - Phone:917-608-5207
Practice Address - Fax:877-515-8647
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16-512246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant