Individual
TANIA CARCHIPULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4277 65TH PL, WOODSIDE, NY 11377-5054
(718) 429-2000
Mailing address
9924 34TH AVE, CORONA, NY 11368-1010
(718) 200-6264
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
772789
NY
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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