Provider Demographics
NPI:1194614305
Name:DECESARE, MAGALYS ALBERTINA
Entity type:Individual
Prefix:
First Name:MAGALYS
Middle Name:ALBERTINA
Last Name:DECESARE
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 1:891 MILLSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8527
Mailing Address - Country:US
Mailing Address - Phone:614-429-8135
Mailing Address - Fax:
Practice Address - Street 1:891 MILLSTREAM DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8527
Practice Address - Country:US
Practice Address - Phone:614-429-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator