MEDICARE: MARIA CECILIA LAGADE MADARIAGA

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	208D00000X	General Practice Physician	344456	NY

General Provider Information

NPI Number	:	1962081828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CECILIA LAGADE MADARIAGA

Provider Business Mailing Address
First Line	:	248 ROUTE 25A STE 960
Second Line	:
City	:	EAST SETAUKET
State	:	NY
Zip	:	11733-2954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	248 ROUTE 25A STE 960
Second Line	:
City	:	EAST SETAUKET
State	:	NY
Zip	:	11733-2954
Country	:	US
Telephone Number	:	631-689-9786
Fax Number	:

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

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	05/30/2026

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Directions to “ MARIA CECILIA LAGADE MADARIAGA ” Practice Location

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