Healthcare Provider Details

I. General information

NPI: 1043130586
Provider Name (Legal Business Name): ASHLEY CARTAGENA MS.ED , SWD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4063 EDSON AVE
BRONX NY
10466-2243
US

IV. Provider business mailing address

4063 EDSON AVE
BRONX NY
10466-2243
US

V. Phone/Fax

Practice location:
  • Phone: 917-655-1500
  • Fax:
Mailing address:
  • Phone: 917-655-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number4245676
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: