Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 148105 | NY |
NPI | 1316953581 |
---|---|
Provider Name | Dr. Cecilia D Cervantes |
First Address | South Ozone Park, NY 11420-3238 |
Second Address | South Ozone Park, NY 11420-3238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01359200 | (05) | NY |
0546931-008 | CIGNA HEALTHCARE (01) | NY |
2122776 | AETNA HMO (01) | NY |
21E741 | EMPIRE BLUE CROSS BLUE SH (01) | NY |
221529 | WELLCARE (01) | NY |
4229484 | AETNA PPO (01) | NY |
62228520 | ATLANTIS HEALTH PLAN (01) | NY |
A61266 | (02) | NY |
AA46377A | MDNY (01) | NY |
IC7303 | HEALTHNET (01) | NY |
P1065136 | OXFORD HEALTH PLAN (01) | NY |