Provider Demographics
NPI:1942462205
Name:CERONE, JENNIFER R BODEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:R BODEN
Last Name:CERONE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:43 NEW SCOTLAND AVENUE
Mailing Address - Street 2:MAIL CODE 101
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-262-5421
Mailing Address - Fax:518-262-5881
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:MAIL CODE 101
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5421
Practice Address - Fax:518-262-5881
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2021-05-12
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Provider Licenses
StateLicense IDTaxonomies
NY2578022080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics