Provider Demographics
NPI:1891380838
Name:CESERANO, JESSICA M
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:M
Last Name:CESERANO
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 1:152 JEROME RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2443
Mailing Address - Country:US
Mailing Address - Phone:646-261-3940
Mailing Address - Fax:
Practice Address - Street 1:152 JEROME RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2443
Practice Address - Country:US
Practice Address - Phone:646-261-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY808250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse