Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | F350247-1 | NY |
NPI | 1063637759 |
---|---|
Provider Name | Christine Anne Cerulo |
First Address | Middletown, NY 10940 |
Second Address | Valhalla, NY 10595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |