Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | 197802 | NY |
NPI | 1255495792 |
---|---|
Provider Name | Dr. Faidherbe Ceus |
First Address | Nanuet, NY 10954-3010 |
Second Address | Nanuet, NY 10954-3010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 21/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4997641 | (05) | MI |