Provider Demographics
NPI:1568638997
Name:OLIVERA, CEDRIC KEIR (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:KEIR
Last Name:OLIVERA
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26481
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11202-6481
Mailing Address - Country:US
Mailing Address - Phone:732-740-4495
Mailing Address - Fax:
Practice Address - Street 1:90 MAIDEN LN
Practice Address - Street 2:FL 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4831
Practice Address - Country:US
Practice Address - Phone:646-290-9560
Practice Address - Fax:212-532-4362
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236536-1207VG0400X
NJMA66558207VG0400X
NY236536207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology