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General NPI Number Information
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NPI Number | 1932465556
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Entity Type | Organization
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Legal Business Name | JESSICA R CESARE, PSYCHOLOGIST, PH.D., P.C.
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 165 N VILLAGE AVE 9
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3761
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Country | US
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Telephone | 516-244-8368
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Fax | 516-572-1426
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Provider Business Mailing Address
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Address Line | 450 SHORE RD 2G
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City | LONG BEACH
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State | NY
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Zip | 11561-5326
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Country | US
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Telephone | 516-244-8368
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Fax | 516-572-1426
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JESSICA RYAN CESARE
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Credential | PH.D.
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Telephone | 516-244-8368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018952
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License Number State | NY
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