Maria Vittoria Carnevale, ANP
Individual provider Active NPI Adult Health Nurse Practitioner · Southport, CT
NPI 1114297629 · NPPES record last updated Jan 1, 2012
Key facts
- NPI
- 1114297629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- F302972-1 (NY)
- Practice address
- 350 Flintlock Rd
Southport, CT 06890-1079 - Phone
- (203) 382-1188
- NPI assigned
- Jan 1, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F302972-1 | NY | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F302972-1 | NY | Yes |
Addresses
Primary practice location
350 Flintlock Rd
Southport, CT 06890-1079
Mailing address
350 Flintlock Rd
Southport, CT 06890-1079
Phone (203) 382-1188
Other providers in Southport, CT
- Bradley Warren Bloom
- Judy L Boslow
- Gretchen H Brandt
- Janet Brown Mendell
- Stephanie Rose Buturla
- Michelle Caserta
- Stacey L Casparius
- Bradford Stephen Chervin
- Noah Stephen Citsay
- Jacalyn Clark
All providers in Southport, CT · Adult Health Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.