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General NPI Number Information
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NPI Number | 1679295489
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Entity Type | Individual
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Provider Name | CECELIA M VALENTIN PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 550 MONTAUK HWY
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City | SHIRLEY
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State | NY
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Zip | 11967-2114
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Country | US
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Telephone | 631-490-3044
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Fax | 631-490-3055
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Provider Business Mailing Address
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Address Line | 42 LOUISIANA AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-4413
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Country | US
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Telephone | 631-681-8581
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404378-01
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License Number State | NY
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