Healthcare Provider Details

I. General information

NPI: 1457416521
Provider Name (Legal Business Name): TRESARA CYRIL BELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLARKSON AVE SUNY DEPARTMENT OF SURGERY
BROOKLYN NY
11203-2056
US

IV. Provider business mailing address

450 CLARKSON AVE SUNY DEPARTMENT OF SURGERY
BROOKLYN NY
11203-2056
US

V. Phone/Fax

Practice location:
  • Phone: 718-270-1421
  • Fax: 718-270-2826
Mailing address:
  • Phone: 718-270-1421
  • Fax: 718-270-2826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA96397
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA96397
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number251773
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberA96397
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number251773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: