Ceregenesis Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CEREGENESIS MEDICAL CORPORATION

Practice address

272 W 107TH St Apt 14C
New York, NY 10025-7834

Phone

(312) 912-2408

NPI assigned

Oct 20, 2026

Last updated

Oct 20, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amir Mansour

Title

Administrative Agent

Phone

(312) 912-2408

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792454400000",
    "number": "1104723550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 W 107TH ST APT 14C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 W 107TH ST APT 14C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257834",
            "telephone_number": "312-912-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREGENESIS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "ADMINISTRATIVE AGENT",
        "authorized_official_telephone_number": "312-912-2408"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven P. Cercy, PH.D.
• Kassandra Cerda, PSYD
• Yafreisy D. Cerda
• Cerebrospinal Neurosurgery Specialties PC
• Julia Peck Cereda, AGACNP-BC
• Catherine Bria Cereghino, MS, FNP
• Suzanne Ceresko
• Heather Xylina Cereste, M.D.
• Juan David Cerezo, MD
• Sarai Cerezo

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.