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NPI Code Detail

MEDICARE: CERRI & DROZ MEDICAL GROUP,LLC

MEDICARE: CERRI & DROZ MEDICAL GROUP,LLC
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
12084P0804XChild & Adolescent Psychiatry Physician
2208000000XPediatrics Physician

General Provider Information

NPI Number : 1427512623
Entity Type Code : Organization
Provider Name (Legal Business Name) : CERRI & DROZ MEDICAL GROUP,LLC
Provider Business Mailing Address
First Line : 24175A OAK PARK DR
Second Line :
City : DOUGLASTON
State : NY
Zip : 11362
Country : US
Telephone Number : 718-210-4255
Fax Number : 516-945-0887
Provider Business Practice Location Address
First Line : 2818 STEINWAY ST
Second Line :
City : ASTORIA
State : NY
Zip : 11103-3349
Country : US
Telephone Number : 718-210-4255
Fax Number : 516-945-0887
Authorized Official
Title or Position : DIRECTOR
Name : DR. RUBEN WALTER CERRI
Credential : MD
Telephone Number : 718-210-4255
Provider Enumeration Date : 01/22/2019
Last Update Date : 01/22/2019

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