Provider Demographics
NPI:1265824494
Name:CEDERBAUMS, INESE B (RPH)
Entity Type:Individual
Prefix:MS
First Name:INESE
Middle Name:B
Last Name:CEDERBAUMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CROTON AV.
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562
Mailing Address - Country:US
Mailing Address - Phone:914-945-0000
Mailing Address - Fax:
Practice Address - Street 1:105 CROTON AV
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562
Practice Address - Country:US
Practice Address - Phone:914-945-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029407-2183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist