Provider Demographics
NPI:1902997240
Name:SIERRA, CESAR A (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:A
Last Name:SIERRA
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 1:162 KINGS HWY N
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2425
Mailing Address - Country:US
Mailing Address - Phone:203-226-1696
Mailing Address - Fax:203-226-7799
Practice Address - Street 1:162 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-2425
Practice Address - Country:US
Practice Address - Phone:203-226-1696
Practice Address - Fax:203-226-7799
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040323207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTH21742Medicare UPIN