Provider Demographics
NPI:1003992074
Name:CEKA, BARI FITZGERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:BARI
Middle Name:FITZGERALD
Last Name:CEKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7098 AMBOY ROAD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-2001
Mailing Address - Country:US
Mailing Address - Phone:718-356-5600
Mailing Address - Fax:
Practice Address - Street 1:7098 AMBOY ROAD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-2001
Practice Address - Country:US
Practice Address - Phone:718-356-5600
Practice Address - Fax:718-304-7598
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234924207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY376AS1OtherEMPIRE BCBS
NY2142996OtherUNITED HEALTH CARE
NY2589643OtherGHI
NY5768046OtherCIGNA
NY5C5416OtherHEALTHNET
NY7103298OtherAETNA
NY2142996OtherUNITED HEALTH CARE
NYH49921Medicare UPIN