Healthcare Provider Details
I. General information
NPI: 1063376010
Provider Name (Legal Business Name): CHANTAL CADESTIN
Entity Type: Individual
Gender:
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
48 S FRANKLIN TPKE STE 104
RAMSEY NJ
07446-2558
US
IV. Provider business mailing address
2 MOUNTAIN AVE
MAHWAH NJ
07430-1218
US
V. Phone/Fax
- Phone: 201-509-8205
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: