Doctor Name: | MS. MARIA VITTORIA CARNEVALE |
NPI Number: | 1114297629 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | F302972-1 |
Business Practice Address: | 350 Flintlock Rd Southport, CT - 068901079 |
Business Phone Number: | 2033821188 |
Business Fax Number: | |
Mailing Address: | 350 Flintlock Rd, SOUTHPORT |
State: | CT |
Postal Code: | 068901079 |
Phone Number: | 2033821188 |
Fax Number: | |
NPI Enumeration Date: | 01/01/2012 |
NPI Last Update Date: | 01/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F302972-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |