Individual
MS. CAROL MARIE SIVERTSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
35 HAGERMAN AVENUE # 3, MEDFORD, NY 11763-2141
(631) 447-6464
(631) 776-8031
Mailing address
35 HAGERMAN AVENUE # 3, MEDFORD, NY 11763-2141
(631) 447-6464
(631) 776-8031
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
416909-1
NY
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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