Healthcare Provider Details

I. General information

NPI: 1265358949
Provider Name (Legal Business Name): CEDAR AND SAGE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BLUE HILL PLZ STE 1509-24
PEARL RIVER NY
10965-3104
US

IV. Provider business mailing address

1 BLUE HILL PLZ STE 1509-24
PEARL RIVER NY
10965-3104
US

V. Phone/Fax

Practice location:
  • Phone: 908-632-8889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH BENNETT-GARGUILO
Title or Position: PMHNP/ OWNER
Credential: PMHNP, FNP
Phone: 908-803-0361