MEDICARE: EILEEN CERAMI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	F332880	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP0365	OTHER	NY	PREFERRED CARE
2	P019332880	OTHER	NY	BLUE CHOICE

General Provider Information

NPI Number	:	1114953213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN CERAMI NP

Provider Business Mailing Address
First Line	:	2365 S CLINTON AVE
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-442-5320
Fax Number	:	585-442-5526

Provider Business Practice Location Address
First Line	:	2365 S CLINTON AVE
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-442-5320
Fax Number	:	585-442-5526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	05/10/2021

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Directions to “ EILEEN CERAMI NP” Practice Location

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