Jacqueline Carrasquillo

Individual provider Active NPI Adult Psychiatric/Mental Health Registered Nurse · Monticello, NY

NPI 1275396129 · NPPES record last updated Mar 1, 2024

Key facts

NPI
1275396129
Entity type
Individual (NPI type 1)
Primary specialty
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X
License
746965 (NY)
Practice address
20 Crystal St
Monticello, NY 12701-1380
Phone
(845) 790-0911
NPI assigned
Feb 2, 2024
Sex
Female
Sole proprietor
No

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
746965NYMDAdult Psychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 746965 NY Yes

Addresses

Primary practice location

20 Crystal St
Monticello, NY 12701-1380

Mailing address

20 Crystal St
Monticello, NY 12701-1380
Phone (845) 790-0911

Other providers in Monticello, NY

All providers in Monticello, NY · Adult Psychiatric/Mental Health Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.