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NPI Code Detail

MEDICARE: CARINA PERROTTA R P.A.-C

MEDICARE: CARINA PERROTTA R P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant009388NY
2207N00000XDermatology Physician009388NY
3207NP0225XPediatric Dermatology Physician009388NY

General Provider Information

NPI Number : 1699071159
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARINA PERROTTA R P.A.-C
Provider Business Mailing Address
First Line : 327 MIDDLE COUNTRY RD
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-2905
Country : US
Telephone Number : 631-979-0909
Fax Number : 631-979-0455
Provider Business Practice Location Address
First Line : 327 MIDDLE COUNTRY RD
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-2905
Country : US
Telephone Number : 631-979-0909
Fax Number : 631-979-0455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2011
Last Update Date : 03/02/2017

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Directions to “ CARINA PERROTTA R P.A.-C” Practice Location

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