MEDICARE: CINDY INES CACERES

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	103TS0200X	School Psychologist	1206799	NY

General Provider Information

NPI Number	:	1952860694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY INES CACERES

Provider Business Mailing Address
First Line	:	3305 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-6407
Country	:	US
Telephone Number	:	718-838-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 FOSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-6407
Country	:	US
Telephone Number	:	718-838-0568
Fax Number	:

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

Provider Enumeration Date	:	03/12/2019
Last Update Date	:	03/12/2019

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Directions to “ CINDY INES CACERES ” Practice Location

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