MEDICARE: ANN MARIE CECERE LCSW

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	103TB0200X	Cognitive & Behavioral Psychologist	44SC04393300	NJ

General Provider Information

NPI Number	:	1255453502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN MARIE CECERE LCSW

Provider Business Mailing Address
First Line	:	6 HORIZON RD
Second Line	:	APT 1806
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6652
Country	:	US
Telephone Number	:	201-816-1808
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 COUNTY RD
Second Line	:	SUITE 1
City	:	CRESSKILL
State	:	NJ
Zip	:	07626-2200
Country	:	US
Telephone Number	:	201-816-1808
Fax Number	:

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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