Provider Demographics
NPI:1760252878
Name:CEPEDA FAX, MARAI J
Entity Type:Individual
Prefix:
First Name:MARAI
Middle Name:J
Last Name:CEPEDA FAX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 WETCHESTER AVE.,
Mailing Address - Street 2:N230
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1133 WETCHESTER AVE.,
Practice Address - Street 2:N230
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604
Practice Address - Country:US
Practice Address - Phone:914-576-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program