Healthcare Provider Details

I. General information

NPI: 1265586168
Provider Name (Legal Business Name): KATHLEEN W CILIONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 HALPIN AVE
STATEN ISLAND NY
10312-1227
US

IV. Provider business mailing address

170 HALPIN AVE
STATEN ISLAND NY
10312-1227
US

V. Phone/Fax

Practice location:
  • Phone: 718-227-1468
  • Fax: 646-452-8202
Mailing address:
  • Phone: 646-452-8200
  • Fax: 646-452-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF400392-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberF400392-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400392-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: