Provider Demographics
NPI:1417150004
Name:CEA, ANN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:C
Last Name:CEA
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 1:244 BYRAM SHORE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6932
Mailing Address - Country:US
Mailing Address - Phone:203-531-4633
Mailing Address - Fax:203-531-4716
Practice Address - Street 1:244 BYRAM SHORE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6932
Practice Address - Country:US
Practice Address - Phone:203-531-4633
Practice Address - Fax:203-531-4716
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1018892085R0001X
CT0165652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61887Medicare UPIN