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NPI Code Detail

MEDICARE: CARLA ROSA DE JESUS

MEDICARE: CARLA ROSA DE JESUS
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
1363LF0000XFamily Nurse Practitioner356687NY

General Provider Information

NPI Number : 1477448033
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA ROSA DE JESUS
Provider Business Mailing Address
First Line : 2918 TENBROECK AVE
Second Line :
City : BRONX
State : NY
Zip : 10469-5229
Country : US
Telephone Number : 917-609-2908
Fax Number :
Provider Business Practice Location Address
First Line : 3709 FLATLANDS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3507
Country : US
Telephone Number : 718-444-7766
Fax Number : 718-444-3709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2025
Last Update Date : 05/16/2026

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Directions to “ CARLA ROSA DE JESUS ” Practice Location

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