Provider Demographics
NPI:1790098374
Name:CEDENO, DARY (LPN)
Entity Type:Individual
Prefix:MS
First Name:DARY
Middle Name:
Last Name:CEDENO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/2 757 B.O. OBRERO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-0000
Mailing Address - Country:US
Mailing Address - Phone:787-728-6504
Mailing Address - Fax:
Practice Address - Street 1:C/2 757 B.O. OBRERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-0000
Practice Address - Country:US
Practice Address - Phone:787-728-6504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32943163W00000X, 164W00000X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163W00000XNursing Service ProvidersRegistered Nurse
No283Q00000XHospitalsPsychiatric Hospital