Individual
DR. CECELIA ACOSTA-LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1894 WALTON AVE, BRONX, NY 10453-6018
(718) 583-3060
Mailing address
1894 WALTON AVE, BRONX, NY 10453-6018
(718) 583-3060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051325
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051325
LICENSE
NY
Enumeration date
08/12/2005
Last updated
03/07/2023
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