Organization
NY FEMALE PELVIC RECONSTRUCTIVE SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC OLIVERA MD (MANAGING MEMBER)
(718) 238-5454
Entity
Organization
Contact information
Practice address
7203 13TH AVE, BROOKLYN, NY 11228
(718) 238-5454
Mailing address
7203 13TH AVE, BROOKLYN, NY 11228-2008
(718) 238-5454
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
236536
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03052540
—
NY
Enumeration date
07/25/2018
Last updated
08/20/2018
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