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NPI Code Detail

MEDICARE: DARRYL P. CERA, D.C., P.C.

MEDICARE: DARRYL P. CERA, D.C., P.C.
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
1111N00000XChiropractorX004009-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11669653655OTHERNYNPI GROUP
21356412753OTHERNPI INDIVIDUAL

General Provider Information

NPI Number : 1669653655
Entity Type Code : Organization
Provider Name (Legal Business Name) : DARRYL P. CERA, D.C., P.C.
Provider Business Mailing Address
First Line : 309 W 99TH ST
Second Line : 1A
City : NEW YORK
State : NY
Zip : 10025-5430
Country : US
Telephone Number : 917-536-1099
Fax Number :
Provider Business Practice Location Address
First Line : 309 W 99TH ST
Second Line : 1A
City : NEW YORK
State : NY
Zip : 10025-5430
Country : US
Telephone Number : 917-536-1099
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. DARRYL P. CERA
Credential : D.C.
Telephone Number : 917-536-1099
Provider Enumeration Date : 11/18/2007
Last Update Date : 12/07/2012

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