Provider Demographics
NPI:1740839901
Name:CEDENO, CHRISTINE ELLEN (CCC,SLP BE)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELLEN
Last Name:CEDENO
Suffix:
Gender:F
Credentials:CCC,SLP BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 CAULDWELL AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7302
Mailing Address - Country:US
Mailing Address - Phone:718-585-0054
Mailing Address - Fax:
Practice Address - Street 1:890 CAULDWELL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7302
Practice Address - Country:US
Practice Address - Phone:718-585-0054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029102-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist