Provider Demographics
NPI:1104180207
Name:CEDENO, ANGELA BENITA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BENITA
Last Name:CEDENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 RIVERDALE AVE
Mailing Address - Street 2:2D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3608
Mailing Address - Country:US
Mailing Address - Phone:646-515-4529
Mailing Address - Fax:
Practice Address - Street 1:3015 RIVERDALE AVE
Practice Address - Street 2:2D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3608
Practice Address - Country:US
Practice Address - Phone:646-515-4529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY84482174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator