Nicholas Mark Cetta
Pediatrician
2901 35th St Lower Level
Kenosha
, Wisconsin 53140
Nicholas Mark Cetta
Pediatrician
2901 35th St Lower Level
Kenosha
, Wisconsin 53140
(262) 652-6552
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Nicholas Mark Cetta
- 2901 35th St Lower Level
- Kenosha, WI
- Zip : 53140
- Fax : (262) 652-6552
- Phone : (262) 652-5115
Second Address
- Nicholas Mark Cetta
- 2901 35th St Lower Level
- Kenosha, WI
- Zip : 53140
- Fax : (262) 652-6552
- Phone : (262) 652-5115
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | WI |
National Provider Identifier
| NPI | 1013019355 |
|---|---|
| Provider Name | Nicholas Mark Cetta |
| First Address | Kenosha, WI 53140 |
| Second Address | Kenosha, WI 53140 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/09/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 32679300 | (05) | WI |
| B52003 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.