Provider Demographics
NPI:1548969090
Name:CACERES, MARIA LORENA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LORENA
Last Name:CACERES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-6982
Mailing Address - Country:US
Mailing Address - Phone:212-974-2222
Mailing Address - Fax:
Practice Address - Street 1:345 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6982
Practice Address - Country:US
Practice Address - Phone:212-974-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator