Healthcare Provider Details
I. General information
NPI: 1144379082
Provider Name (Legal Business Name): SVETLANA KARASINA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44 MAYFLOWER DR
BASKING RIDGE NJ
07920-3818
US
IV. Provider business mailing address
44 MAYFLOWER DR
BASKING RIDGE NJ
07920-3818
US
V. Phone/Fax
- Phone: 908-470-0736
- Fax: 908-326-3607
- Phone: 908-470-0736
- Fax: 908-326-3607
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WR0006X |
| Taxonomy | Registered Nurse First Assistant |
| License Number | 26NR08857300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: