Healthcare Provider Details

I. General information

NPI: 1801481536
Provider Name (Legal Business Name): MARIA MONICA CARMONA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W AMES CT STE 100
PLAINVIEW NY
11803-2304
US

IV. Provider business mailing address

116 PILGRIM PL
VALLEY STREAM NY
11580-5339
US

V. Phone/Fax

Practice location:
  • Phone: 516-427-1423
  • Fax:
Mailing address:
  • Phone: 718-683-7384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number403239
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: