Individual
MS. DAWNELL CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 RIVIERA DR E, MASSAPEQUA, NY 11758-8511
(516) 799-2214
Mailing address
11 RIVIERA DR E, MASSAPEQUA, NY 11758-8511
(516) 799-2214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
403603
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
381956
NY
Other
Enumeration date
07/28/2009
Last updated
01/27/2011
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