Provider Demographics
NPI:1104970722
Name:CAESAR, ARTURO AUGUSTO (MD)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:AUGUSTO
Last Name:CAESAR
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 1:470 MALCOLM X BLVD
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3003
Mailing Address - Country:US
Mailing Address - Phone:347-729-9843
Mailing Address - Fax:
Practice Address - Street 1:470 MALCOLM X BLVD
Practice Address - Street 2:SUITE 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3003
Practice Address - Country:US
Practice Address - Phone:347-729-9843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138922207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01132892Medicaid
NY01132892Medicaid