Provider Demographics
NPI:1811103880
Name:NORBERTO, CANDIDO CESAR (MD)
Entity type:Individual
Prefix:DR
First Name:CANDIDO
Middle Name:CESAR
Last Name:NORBERTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2742 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4913
Mailing Address - Country:US
Mailing Address - Phone:212-568-4390
Mailing Address - Fax:
Practice Address - Street 1:106 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4715
Practice Address - Country:US
Practice Address - Phone:212-568-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160621208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160621OtherNEW YORK STATE LICENSE