Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | X004009-1 | NY |
NPI | 1356412753 |
---|---|
Provider Name | Dr. Darryl Peter Cera |
First Address | New York, NY 10025-5416 |
Second Address | New York, NY 10025-5416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 07/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CD 470946 | GHI (01) | NY |
X58741 | (02) | NY |