Provider Demographics
NPI:1447255062
Name:CEFARATTI, MICHAEL D (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:CEFARATTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2630 WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1130
Mailing Address - Country:US
Mailing Address - Phone:610-376-1981
Mailing Address - Fax:610-376-3153
Practice Address - Street 1:2630 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1130
Practice Address - Country:US
Practice Address - Phone:610-376-1981
Practice Address - Fax:610-376-3153
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD007057E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007175160002Medicaid
PA0007175160002Medicaid
B32942Medicare UPIN