Blanca Patricia Carballido

Individual provider Active NPI Registered Nurse · East Patchogue, NY

NPI 1194951376 · NPPES record last updated Jun 2, 2009

Key facts

NPI
1194951376
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
533381 (NY)
Practice address
932 Americus Ave
East Patchogue, NY 11772-5019
Phone
(631) 803-2895
Fax
(631) 803-2895
NPI assigned
Jun 2, 2009
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

LicenseStateTypeSpecialty
533381NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 533381 NY Yes

Addresses

Primary practice location

932 Americus Ave
East Patchogue, NY 11772-5019

Mailing address

932 Americus Ave
East Patchogue, NY 11772-5019
Phone (631) 803-2895

Other providers in East Patchogue, NY

All providers in East Patchogue, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.