Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 2007018505 | MO |
Y | 2080P0204X | Pediatric Emergency Doctor | 46962 | AZ |
NPI | 1194922005 |
---|---|
Provider Name | Dr. Keren Eliany Cedillos |
First Address | Phoenix, AZ 85016-7710 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 25/10/2017 |