Healthcare Provider Details

I. General information

NPI: 1811972698
Provider Name (Legal Business Name): SILVIO JOHN CECCARELLI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 THEALL RD
RYE NY
10580-1404
US

IV. Provider business mailing address

1 THEALL RD
RYE NY
10580-1404
US

V. Phone/Fax

Practice location:
  • Phone: 914-848-8700
  • Fax: 914-848-8701
Mailing address:
  • Phone: 914-848-8700
  • Fax: 914-848-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number148605
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number027982
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: