Individual
CONSTANCE DECARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 FOREST RD W, MASTIC BEACH, NY 11951-5820
(631) 281-3712
Mailing address
313 FOREST RD W, MASTIC BEACH, NY 11951-5820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
263714
NY
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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