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General NPI Number Information
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NPI Number | 1497234173
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Entity Type | Individual
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Provider Name | STEPHANIE CERNIGLIA ATC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 1000 HEMPSTEAD TPKE
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City | HEMPSTEAD
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State | NY
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Zip | 11549-0100
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Country | US
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Telephone | 516-483-6077
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Fax |
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Provider Business Mailing Address
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Address Line | 233 ROOSEVELT AVE
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City | FREEPORT
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State | NY
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Zip | 11520-5411
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Country | US
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Telephone | 518-847-8490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 003726-1
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License Number State | NY
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