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Individual

KRISTIN CARNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
762 DEER PARK RD, DIX HILLS, NY 11746-6221
(631) 254-0094
Mailing address
3887 MILL RD, SEAFORD, NY 11783-1800
(516) 286-1276

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007607-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007607-1
PTA CERTIFICATION
NY
Enumeration date
02/27/2018
Last updated
03/17/2018
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