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General NPI Number Information
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NPI Number | 1063473742
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Entity Type | Individual
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Provider Name | MANUEL A CEJA MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | BUILDING 75 STE 247249 JFK INTERNATIONAL AIRPORT
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City | JAMAICA
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State | NY
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Zip | 11430-1802
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Country | US
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Telephone | 718-656-9500
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Fax | 718-656-9503
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Provider Business Mailing Address
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Address Line | 4840 194TH ST
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City | FLUSHING
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State | NY
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Zip | 11365-1222
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Country | US
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Telephone | 718-428-4295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 174494
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 174494
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License Number State | NY
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