Provider Demographics
NPI:1700832250
Name:CERVANTES, JOCELYN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:M
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2035 LAKEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1661
Mailing Address - Country:US
Mailing Address - Phone:718-343-0600
Mailing Address - Fax:718-343-0169
Practice Address - Street 1:2035 LAKEVILLE RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1661
Practice Address - Country:US
Practice Address - Phone:718-343-0600
Practice Address - Fax:718-343-0169
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY182681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9255SDMedicare ID - Type Unspecified
NYE82400Medicare UPIN
NY00086Medicare ID - Type Unspecified
NY9255LQMedicare ID - Type Unspecified