Healthcare Provider Details

I. General information

NPI: 1295118008
Provider Name (Legal Business Name): CARMELLE CIME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL
NEW YORK NY
10029-6504
US

IV. Provider business mailing address

3 E EVERGREEN RD # 219
NEW CITY NY
10956-5145
US

V. Phone/Fax

Practice location:
  • Phone: 347-613-2824
  • Fax: 929-622-7040
Mailing address:
  • Phone: 347-613-2824
  • Fax: 929-622-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339865
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406452
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: