Individual
ANTONIO CARABALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 W LEHIGH AVE, PHILADELPHIA, PA 19133-2227
(215) 229-8857
Mailing address
2409 S LEE ST, PHILADELPHIA, PA 19148-4105
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15349700
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP032747
PA
Other
Enumeration date
04/22/2025
Last updated
05/07/2026
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