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NPI Code Detail

MEDICARE: BERNY CEAN

MEDICARE: BERNY CEAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician8934NY

General Provider Information

NPI Number : 1275207326
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNY CEAN
Provider Business Mailing Address
First Line : 1 CVS DRIVE
Second Line : MAIL STOP #3005
City : WOONSOCKET
State : RI
Zip : 02895
Country : US
Telephone Number : 401-770-2286
Fax Number : 401-269-4731
Provider Business Practice Location Address
First Line : 10204 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-2810
Country : US
Telephone Number : 718-257-1099
Fax Number : 718-257-4033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2021
Last Update Date : 08/03/2021

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