MEDICARE: CARLA S SIGUENZA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	829714-01	NY

General Provider Information

NPI Number	:	1245001767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA S SIGUENZA RN

Provider Business Mailing Address
First Line	:	2536 BUTLER ST
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-1645
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2536 BUTLER ST
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-1645
Country	:	US
Telephone Number	:	347-840-1126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	01/12/2024

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