Healthcare Provider Details

I. General information

NPI: 1871035717
Provider Name (Legal Business Name): CASSANDRA ANN CESAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 216TH ST
BAYSIDE NY
11360-2810
US

IV. Provider business mailing address

2901 216TH ST
BAYSIDE NY
11360-2810
US

V. Phone/Fax

Practice location:
  • Phone: 718-291-8800
  • Fax:
Mailing address:
  • Phone: 718-291-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF355799
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number327234
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: