Healthcare Provider Details

I. General information

NPI: 1346151982
Provider Name (Legal Business Name): NAYOUNG CELENTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 BRIDGEPORT AVE
MILFORD CT
06460-4647
US

IV. Provider business mailing address

7 PEPPERMILL DR
WEST HAVEN CT
06516-6636
US

V. Phone/Fax

Practice location:
  • Phone: 203-890-9777
  • Fax:
Mailing address:
  • Phone: 203-464-8963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.018345
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: