Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 000092 | PR |
NPI | 1275751000 |
---|---|
Provider Name | Dr. Maria Teresa Cedeno |
First Address | Toa Baja, PR 00949 |
Second Address | Levittown, PR 00949-4136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U72010 | (02) | PR |