Provider Demographics
NPI:1619285301
Name:CESAIRE, MARJORIE (CRNA)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:CESAIRE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE APT 1228
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-1340
Mailing Address - Fax:
Practice Address - Street 1:777 S EDEN ST
Practice Address - Street 2:APT 1228
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3362
Practice Address - Country:US
Practice Address - Phone:732-910-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA085265367500000X
MDR189034367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered