Provider Demographics
NPI:1215024914
Name:CESTERO, YOLANDA A (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:A
Last Name:CESTERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 STOWE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2570
Mailing Address - Country:US
Mailing Address - Phone:914-737-1497
Mailing Address - Fax:914-000-0000
Practice Address - Street 1:2 STOWE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2570
Practice Address - Country:US
Practice Address - Phone:914-737-1497
Practice Address - Fax:914-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY114255207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002091052Medicaid
NY002091052Medicaid
YC05826810Medicare PIN
B16926Medicare UPIN