Provider Demographics
NPI:1679295489
Name:VALENTIN, CECELIA M (PMHNP)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:M
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:42 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-4413
Mailing Address - Country:US
Mailing Address - Phone:631-681-8581
Mailing Address - Fax:
Practice Address - Street 1:550 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2114
Practice Address - Country:US
Practice Address - Phone:631-490-3044
Practice Address - Fax:631-490-3055
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF404378-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health