Individual
KEVIN J DICESARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 W. 27TH STREET, SUITE 5S, NEW YORK, NY 10001
(833) 351-8255
(888) 815-3583
Mailing address
109 W. 27TH STREET, SUITE 5S, NEW YORK, NY 10001
(833) 351-8255
(888) 815-3583
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
12784
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01Y008391NH01
ANTHEM ACES #
NH
01
—
2042889
CIGNA BH PIN
NH
05
—
30205115
—
NH
01
—
794877
MVP PIN
NH
Enumeration date
03/23/2006
Last updated
04/11/2025
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