Individual
MR. JEFFERSON JUNIOR CELUS CESAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 424-7431
Mailing address
400 SUNRISE HWY, AMITYVILLE, NY 11701-2508
(631) 264-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
634746
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402247
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04840653
—
NY
Enumeration date
12/11/2010
Last updated
06/16/2018
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