Individual
CARLINE MONDESIR LAROCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 W 97TH ST, NEW YORK, NY 10025-6450
(212) 749-1820
Mailing address
279 SEAVIEW AVE, JERSEY CITY, NJ 07305-1716
(917) 803-9926
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
293223
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293223
LICENSE NUMBER
NY
Enumeration date
08/06/2020
Last updated
08/06/2020
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