Provider Demographics
NPI:1437243367
Name:CESARI, ANDREW PHILLIP (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PHILLIP
Last Name:CESARI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2636
Mailing Address - Country:US
Mailing Address - Phone:607-733-5586
Mailing Address - Fax:607-733-7014
Practice Address - Street 1:451 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2636
Practice Address - Country:US
Practice Address - Phone:607-733-5586
Practice Address - Fax:607-733-7014
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0356481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00666564Medicaid