Provider Demographics
NPI:1356697015
Name:CERASO, JOANNE MICHELLLE
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MICHELLLE
Last Name:CERASO
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 1:80 5TH AVE
Mailing Address - Street 2:SUITE 903
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8002
Mailing Address - Country:US
Mailing Address - Phone:212-633-9162
Mailing Address - Fax:
Practice Address - Street 1:201 E 66TH ST
Practice Address - Street 2:APARTMENT 4DE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6451
Practice Address - Country:US
Practice Address - Phone:917-797-9498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor