Healthcare Provider Details

I. General information

NPI: 1093055014
Provider Name (Legal Business Name): CARLINE POMPEE REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 STATE ROUTE 32
MODENA NY
12548-5017
US

IV. Provider business mailing address

2051 STATE ROUTE 32
MODENA NY
12548-5017
US

V. Phone/Fax

Practice location:
  • Phone: 845-866-5319
  • Fax:
Mailing address:
  • Phone: 845-866-5319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number450993-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF03260763
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: