Ceresa, Marie

Ceresa, Marie is an individual health care provider with primary practice located at 260 E 188Th St , Bronx NY 10458-5302. She recently has only one registered license in Other Service Providers / Health Educator, which is considered as her primary health care specialty. Ceresa, Marie can be contacted via phone (718) 618-8049.

Contact Information

Primary practice address
260 E 188Th St Bronx NY 10458-5302
Phone: (718) 618-8049
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X

Profile Details

NPI number 1578197794
LBN Legal business name Ceresa, Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2020
Last updated Feb 26th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578197794 NPPES
New York MEDICAID 02064111

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