Healthcare Provider Details

I. General information

NPI: 1649189978
Provider Name (Legal Business Name): ARIANA C STEFANIDIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 BERKLEY RD
MINEOLA NY
11501-4605
US

IV. Provider business mailing address

46 BERKLEY RD
MINEOLA NY
11501-4605
US

V. Phone/Fax

Practice location:
  • Phone: 516-306-6393
  • Fax:
Mailing address:
  • Phone: 516-306-6393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number851187-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: