Healthcare Provider Details
I. General information
NPI: 1336066984
Provider Name (Legal Business Name): DEBORAH CERNUTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27 MATTHEWS ST
GOSHEN NY
10924-1962
US
IV. Provider business mailing address
4316 WHISPERING HLS
CHESTER NY
10918-1577
US
V. Phone/Fax
- Phone: 845-801-5793
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: