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General NPI Number Information
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NPI Number | 1932520129
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Entity Type | Organization
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Legal Business Name | CARLA LYNN SANGIORGIO
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Dates
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Enumeration Date | 12/15/2013
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Last Update Date | 12/15/2013
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Provider Practice Location Address
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Address Line | 1080 RENSSELAER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2114
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Country | US
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Telephone | 718-227-2466
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Fax |
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Provider Business Mailing Address
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Address Line | 1080 RENSSELAER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10309-2114
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Country | US
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Telephone | 718-227-2466
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Fax |
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Authorized Official
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Title or Position | RN NURSE
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Name | MS. CARLA LYNN SANGIORGIO
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Credential | R.N
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Telephone | 718-227-2466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 671937
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License Number State | NY
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