Healthcare Provider Details

I. General information

NPI: 1629695721
Provider Name (Legal Business Name): JEISSY ESTHER CIPRIAN F. SR. MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. TOA ALTA HEIGHTS AN3 #33 00953 TOA ALTA HEIGHTS AN3 #33 00953
TOA ALTA PR
00953
US

IV. Provider business mailing address

URB. TOA ALTA HEIGHTS AN3 #33 00953 TOA ALTA HEIGHTS AN3 #33 00953
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-399-3159
  • Fax:
Mailing address:
  • Phone: 787-399-3159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number025114
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: