Individual
KEVIN CERQUEIRA SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 YORK AVE # C1272, NEW YORK, NY 10065
(212) 639-2000
Mailing address
1275 YORK AVE # C1272, NEW YORK, NY 10065-6007
(212) 639-2000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
012680000
MA
2086X0206X
Surgical Oncology Physician
Primary
286381
NY
Other
Enumeration date
03/24/2009
Last updated
01/28/2019
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