Provider Demographics
NPI:1821150509
Name:HADDA, CERI E (MD)
Entity Type:Individual
Prefix:DR
First Name:CERI
Middle Name:E
Last Name:HADDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:79 W 12TH ST
Mailing Address - Street 2:APARTMENT 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8565
Mailing Address - Country:US
Mailing Address - Phone:212-924-6798
Mailing Address - Fax:212-434-3306
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1851
Practice Address - Country:US
Practice Address - Phone:212-831-3005
Practice Address - Fax:212-434-3306
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2012-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2077472084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH41302Medicare UPIN
NY007BD2Medicare ID - Type Unspecified