Healthcare Provider Details

I. General information

NPI: 1407766561
Provider Name (Legal Business Name): MRS. STEFFANY S AWITY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 SHERMAN AVE APT 5D
BRONX NY
10456-6447
US

IV. Provider business mailing address

968 SHERMAN AVE APT 5D
BRONX NY
10456-6447
US

V. Phone/Fax

Practice location:
  • Phone: 646-330-1186
  • Fax:
Mailing address:
  • Phone: 646-330-1186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number307906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: