Basic Information
| Provider Information | |||||||||
| NPI: | 1811972698 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CECCARELLI | ||||||||
| FirstName: | SILVIO | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 THEALL RD | ||||||||
| Address2: | |||||||||
| City: | RYE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105801404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148488700 | ||||||||
| FaxNumber: | 9148488701 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 THEALL RD | ||||||||
| Address2: | |||||||||
| City: | RYE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105801404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148488700 | ||||||||
| FaxNumber: | 9148488701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 12/26/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 148605 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 027982 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 133884168 | 01 | NY | EMPIRE STATE PLAN (NYS) | OTHER | 133884168 | 01 | NY | POMCO | OTHER | 148605 | 01 | NY | CONNECTICARE | OTHER | 148605-9 | 01 | NY | WORKERS COMPENSATION | OTHER | 8279 | 01 | NY | PHCS | OTHER | 0994674 | 05 | NY | MEDICAID | 4360135 | 01 | NY | AETNA NON HMO | OTHER | 86D691 | 01 | NY | BLUE CROSS PPO | OTHER | WP297 | 01 | NY | OXFORD | OTHER | 0307888-007 | 01 | NY | CIGNA | OTHER | 110142525 | 01 | NY | RAILROAD MEDICARE | OTHER | 133884168 | 01 | NY | BEECH STREET | OTHER | 493761 | 01 | NY | AETNA HMO | OTHER | 0032002 | 01 | NY | GHI PPO | OTHER | 1320459 | 01 | NY | UNITED HEALTH CARE | OTHER | 133884168 | 01 | NY | MULTIPLAN | OTHER | ODO865/2C9222 | 01 | NY | HEALTH NET | OTHER |