Provider Demographics
NPI:1023412525
Name:CERLAR MEDICINE, PC
Entity type:Organization
Organization Name:CERLAR MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-533-0270
Mailing Address - Street 1:400 RELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4241
Mailing Address - Country:US
Mailing Address - Phone:845-533-0270
Mailing Address - Fax:845-623-3714
Practice Address - Street 1:365 NY 304
Practice Address - Street 2:SUITE 204
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954
Practice Address - Country:US
Practice Address - Phone:845-533-0270
Practice Address - Fax:845-623-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228195207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty