Healthcare Provider Details

I. General information

NPI: 1457200842
Provider Name (Legal Business Name): CHERICE STEBBINS NP IN FAMILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 S MAIN ST STE 4
CENTRAL SQUARE NY
13036-3534
US

IV. Provider business mailing address

662 S MAIN ST STE 4
CENTRAL SQUARE NY
13036-3534
US

V. Phone/Fax

Practice location:
  • Phone: 315-920-0841
  • Fax: 315-367-7184
Mailing address:
  • Phone: 315-920-0841
  • Fax: 315-367-7184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHERICE MARIE STEBBINS
Title or Position: PRACTICE OWNER
Credential: NP
Phone: 315-715-2274