Provider Demographics
NPI:1740511385
Name:DRAKES-CHESTER, CEYON M (APN)
Entity type:Individual
Prefix:MRS
First Name:CEYON
Middle Name:M
Last Name:DRAKES-CHESTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:CEYON
Other - Middle Name:
Other - Last Name:BELIZAIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:150 BERGEN ST
Mailing Address - Street 2:UMDNJ UNIVERSITY HOSPITAL I 246
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2496
Mailing Address - Country:US
Mailing Address - Phone:973-972-4773
Mailing Address - Fax:973-972-5444
Practice Address - Street 1:150 BERGEN ST
Practice Address - Street 2:UMDNJ UNIVERSITY HOSPITAL I 246
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-4773
Practice Address - Fax:973-972-5444
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00276500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0289591Medicaid
NJ0289591Medicaid