Healthcare Provider Details

I. General information

NPI: 1427512623
Provider Name (Legal Business Name): CERRI & DROZ MEDICAL GROUP,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 STEINWAY ST
ASTORIA NY
11103-3349
US

IV. Provider business mailing address

24175A OAK PARK DR
DOUGLASTON NY
11362
US

V. Phone/Fax

Practice location:
  • Phone: 718-210-4255
  • Fax: 516-945-0887
Mailing address:
  • Phone: 718-210-4255
  • Fax: 516-945-0887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RUBEN WALTER CERRI
Title or Position: DIRECTOR
Credential: MD
Phone: 718-210-4255