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General NPI Number Information
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NPI Number | 1144258153
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Entity Type | Individual
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Provider Name | KATHLEEN CARIDI NP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 375 SEGUINE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-3932
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Country | US
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Telephone | 718-226-6186
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Fax |
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Provider Business Mailing Address
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Address Line | 154 PACIFIC AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5606
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Country | US
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Telephone | 347-677-4645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00122000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F331556-1
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License Number State | NY
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