Provider Demographics
NPI:1700342581
Name:KATHERINE T CERIO MD PLLC
Entity Type:Organization
Organization Name:KATHERINE T CERIO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CERIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-743-4086
Mailing Address - Street 1:3070 BELGIUM RD
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9546
Mailing Address - Country:US
Mailing Address - Phone:315-743-4086
Mailing Address - Fax:
Practice Address - Street 1:3070 BELGIUM RD
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-9546
Practice Address - Country:US
Practice Address - Phone:315-743-4086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty