Healthcare Provider Details

I. General information

NPI: 1265383079
Provider Name (Legal Business Name): SHEICA CEDANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2578 BROADWAY
NEW YORK NY
10025-5642
US

IV. Provider business mailing address

2578 BROADWAY UNIT A135
NEW YORK NY
10025-5642
US

V. Phone/Fax

Practice location:
  • Phone: 800-305-7153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: