MEDICARE: CERES JOY RESPICIO

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1255733259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CERES JOY RESPICIO

Provider Business Mailing Address
First Line	:	3175 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5700
Country	:	US
Telephone Number	:	917-345-6266
Fax Number	:	212-397-2237

Provider Business Practice Location Address
First Line	:	3175 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5700
Country	:	US
Telephone Number	:	917-345-6266
Fax Number	:	212-397-2237

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

Provider Enumeration Date	:	09/22/2014
Last Update Date	:	11/10/2020

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Directions to “ CERES JOY RESPICIO ” Practice Location

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