Doctor Name: | ANNA CARROLL |
NPI Number: | 1255729802 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F306998-1 |
Business Practice Address: | 3001 Expressway Dr N Suite 104 Islandia, NY - 117495301 |
Business Phone Number: | 6314350110 |
Business Fax Number: | 6314354582 |
Mailing Address: | 3001 Expressway Dr N, Suite 104 ISLANDIA |
State: | NY |
Postal Code: | 117495301 |
Phone Number: | 6314350110 |
Fax Number: | 6314354582 |
NPI Enumeration Date: | 01/06/2015 |
NPI Last Update Date: | 01/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | F306998-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |