Provider Demographics
NPI:1376248617
Name:CEASER, MARATANIA (CPHT)
Entity Type:Individual
Prefix:
First Name:MARATANIA
Middle Name:
Last Name:CEASER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:MARATANIA
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPHT
Mailing Address - Street 1:2817 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1366
Mailing Address - Country:US
Mailing Address - Phone:757-496-9636
Mailing Address - Fax:757-496-8836
Practice Address - Street 1:2817 SHORE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1366
Practice Address - Country:US
Practice Address - Phone:757-496-9636
Practice Address - Fax:757-496-8836
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230009805183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician