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1205928603 NPI number — VICENTA CACERES M.D.

NPI Number: 1205928603
Health Care Provider/Practitioner: VICENTA CACERES M.D.

Information about “1205928603” NPI (VICENTA CACERES M.D.) exists in 1205928603 in HTML format HTML  |  1205928603 in plain Text format TXT  |  1205928603 in PDF (Portable Document Format) PDF  |  1205928603 in an XML format XML  formats.

NPI Number : 1205928603 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205928603",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CACERES",
    "FirstName": "VICENTA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CACERES DE LOPEZ",
    "OtherFirstName": "VICENTA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "200 W 57TH ST",
    "SecondLineMailingAddress": "15TH FLOOR",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10019-3211",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-333-7883",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "200 W 57TH ST",
    "SecondLinePracticeLocationAddress": "15TH FLOOR",
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10019-3211",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-333-7883",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/29/2006",
    "LastUpdateDate": "02/21/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RG0100X",
        "TaxonomyName": "Gastroenterology Physician",
        "LicenseNumber": "193906",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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