Provider Demographics
NPI:1700552593
Name:CEDRI, KAYLEE ANN (F-NP)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ANN
Last Name:CEDRI
Suffix:
Gender:F
Credentials:F-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 SOUTHWESTERN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1762
Mailing Address - Country:US
Mailing Address - Phone:716-362-3909
Mailing Address - Fax:716-608-6022
Practice Address - Street 1:3775 SOUTHWESTERN BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1762
Practice Address - Country:US
Practice Address - Phone:716-362-3909
Practice Address - Fax:716-608-6022
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347949-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner