Provider Demographics
NPI:1639137532
Name:CERON, OLGA M (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:M
Last Name:CERON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5 NEPONSET ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-856-9599
Mailing Address - Fax:508-854-4998
Practice Address - Street 1:5 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-856-9599
Practice Address - Fax:508-854-4998
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2018-09-26
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Provider Licenses
StateLicense IDTaxonomies
MA223789207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110075888AMedicaid
MAS400158571Medicare PIN