Healthcare Provider Details

I. General information

NPI: 1679404792
Provider Name (Legal Business Name): CELESTE DUNHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 HAMILTON ST
PATERSON NJ
07505-2003
US

IV. Provider business mailing address

17 COLLEGE PL
RUTHERFORD NJ
07070-2621
US

V. Phone/Fax

Practice location:
  • Phone: 732-674-9857
  • Fax:
Mailing address:
  • Phone: 201-320-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00337500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: