Provider Demographics
NPI:1891186045
Name:CACERES, MARIA (RDMS(AB))
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CACERES
Suffix:
Gender:F
Credentials:RDMS(AB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 FOSTER PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1805
Mailing Address - Country:US
Mailing Address - Phone:201-429-7248
Mailing Address - Fax:
Practice Address - Street 1:216 FOSTER PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471
Practice Address - Country:US
Practice Address - Phone:201-492-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1225362471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography