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General NPI Number Information
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NPI Number | 1780969535
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Entity Type | Organization
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Legal Business Name | CECILIA TESORO ARBOLEDA, MDPC
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 4305 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-3601
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Country | US
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Telephone | 845-229-0790
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Fax | 845-229-1749
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Provider Business Mailing Address
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Address Line | 4305 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-3601
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Country | US
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Telephone | 845-229-0790
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Fax | 845-229-1749
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CECILIA TESORO ARBOLEDA
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Credential | M.D.
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Telephone | 845-229-0790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 117294
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License Number State | NY
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