Healthcare Provider Details

I. General information

NPI: 1609720465
Provider Name (Legal Business Name): GUERARDINE CANTAVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CADMAN PLZ W
BROOKLYN NY
11201-3229
US

IV. Provider business mailing address

198 ELM ST
VALLEY STREAM NY
11580-4916
US

V. Phone/Fax

Practice location:
  • Phone: 917-801-9150
  • Fax: 929-567-2881
Mailing address:
  • Phone: 516-967-9868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: