Healthcare Provider Details

I. General information

NPI: 1700089117
Provider Name (Legal Business Name): CAROLYN A LIFRIERI MSN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 LAFAYETTE AVE
SUFFERN NY
10901-4812
US

IV. Provider business mailing address

23 WOODBINE RD
NEW CITY NY
10956-2418
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-5000
  • Fax: 845-368-5608
Mailing address:
  • Phone: 845-634-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334766-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: