MEDICARE: BARBARA CAROTENUTO

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	126800000X	Dental Assistant

General Provider Information

NPI Number	:	1275297525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA CAROTENUTO

Provider Business Mailing Address
First Line	:	19040 MONTEREY AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19040 MONTEREY AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-1610
Country	:	US
Telephone Number	:	667-544-0021
Fax Number	:

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

Provider Enumeration Date	:	10/23/2021
Last Update Date	:	10/23/2021

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Directions to “ BARBARA CAROTENUTO ” Practice Location

Language	Start Address	Practice Location

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