Healthcare Provider Details

I. General information

NPI: 1710817838
Provider Name (Legal Business Name): STEPHANIE L. CENAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N BAYVIEW AVE
FREEPORT NY
11520-1938
US

IV. Provider business mailing address

114 N BAYVIEW AVE
FREEPORT NY
11520-1938
US

V. Phone/Fax

Practice location:
  • Phone: 917-939-9530
  • Fax: 917-939-9530
Mailing address:
  • Phone: 917-939-9530
  • Fax: 917-939-9530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number122900-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: