Healthcare Provider Details

I. General information

NPI: 1275447989
Provider Name (Legal Business Name): KARLA PINEDA NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 NAMEOKE ST APT 6D
FAR ROCKAWAY NY
11691-4913
US

IV. Provider business mailing address

1011 NAMEOKE ST APT 6D
FAR ROCKAWAY NY
11691-4913
US

V. Phone/Fax

Practice location:
  • Phone: 347-301-9587
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408777
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: