Healthcare Provider Details

I. General information

NPI: 1609730522
Provider Name (Legal Business Name): MARIA CECILIA PINEDA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 OCEAN AVE S
ARVERNE NY
11692-2309
US

IV. Provider business mailing address

6405 OCEAN AVE S
ARVERNE NY
11692-2309
US

V. Phone/Fax

Practice location:
  • Phone: 646-461-0558
  • Fax:
Mailing address:
  • Phone: 646-461-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number358392
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: