MEDICARE: PETER CARANESE

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	34665	NY

General Provider Information

NPI Number	:	1295523009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER CARANESE

Provider Business Mailing Address
First Line	:	750 67TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5621
Country	:	US
Telephone Number	:	917-903-6266
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3521
Country	:	US
Telephone Number	:	347-543-3543
Fax Number	:

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

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	04/30/2025

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Directions to “ PETER CARANESE ” Practice Location

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