Healthcare Provider Details

I. General information

NPI: 1316230634
Provider Name (Legal Business Name): JOANNE DUNCAN-CARNESCIALI RCEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 W 57TH ST APARTMENT 61A
NEW YORK NY
10019-3301
US

IV. Provider business mailing address

112 W 56TH ST APARTMENT 9N
NEW YORK NY
10019-3841
US

V. Phone/Fax

Practice location:
  • Phone: 212-757-2459
  • Fax:
Mailing address:
  • Phone: 917-494-7215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number1019134
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number21510482
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number24366
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: