Healthcare Provider Details

I. General information

NPI: 1740320779
Provider Name (Legal Business Name): MARIA R CELENTANO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 TUCKAHOE RD
YONKERS NY
10710-5704
US

IV. Provider business mailing address

1 STONELEIGH PLAZA APT. 1S
BRONXVILLE NY
10708
US

V. Phone/Fax

Practice location:
  • Phone: 914-779-5133
  • Fax:
Mailing address:
  • Phone: 914-961-0152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047007
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: