Healthcare Provider Details

I. General information

NPI: 1144103946
Provider Name (Legal Business Name): CACTUS PEAR SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4306 46TH ST APT 4E
SUNNYSIDE NY
11104-2009
US

IV. Provider business mailing address

4306 46TH ST APT 4E
SUNNYSIDE NY
11104-2009
US

V. Phone/Fax

Practice location:
  • Phone: 347-841-1416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SALLY GHANY
Title or Position: OWNER
Credential:
Phone: 347-841-1416