MEDICARE: MRS. CAROL PERRINI MSED

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	174H00000X	Health Educator
2	174H00000X	Health Educator		NY

General Provider Information

NPI Number	:	1346528395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROL PERRINI MSED

Provider Business Mailing Address
First Line	:	331 BEACH 149TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11694-1026
Country	:	US
Telephone Number	:	646-642-7226
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 BEACH 149TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11694-1026
Country	:	US
Telephone Number	:	646-642-7226
Fax Number	:

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	07/21/2022

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