Individual
CARENA LAUREL WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11220 LIBERTY AVE, SOUTH RICHMOND HILL, NY 11419-1814
(718) 554-6600
Mailing address
1555 SAINT MARKS AVE, BROOKLYN, NY 11233-4723
(718) 825-5060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F342127-1
NY
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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