Individual
CARLENE M GITTENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1455 GENEVA LOOP, 11C, BROOKLYN, NY 11239-2419
(718) 942-0173
Mailing address
1455 GENEVA LOOP, 11C, BROOKLYN, NY 11239-2419
(718) 942-0173
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NY
174400000X
Specialist
Primary
—
NY
251B00000X
Case Management Agency
—
NY
252Y00000X
Early Intervention Provider Agency
—
NY
Other
Enumeration date
08/02/2012
Last updated
08/06/2012
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