Healthcare Provider Details

I. General information

NPI: 1447241534
Provider Name (Legal Business Name): CARMEN ROSA ARROYO MS/CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2005
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 TOMPKINS AVE
STATEN ISLAND NY
10304-2601
US

IV. Provider business mailing address

119 TOMPKINS AVE
STATEN ISLAND NY
10304-2601
US

V. Phone/Fax

Practice location:
  • Phone: 917-485-7752
  • Fax: 718-551-0339
Mailing address:
  • Phone: 917-485-7752
  • Fax: 718-551-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00068100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382690-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: