MEDICARE: CHRISTINE CARRIERI

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	363LF0000X	Family Nurse Practitioner	342925	NY

General Provider Information

NPI Number	:	1922587310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE CARRIERI

Provider Business Mailing Address
First Line	:	440 SEGUINE AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3936
Country	:	US
Telephone Number	:	917-763-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	5947 AMBOY RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-3118
Country	:	US
Telephone Number	:	718-605-2970
Fax Number	:

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	08/07/2018

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Directions to “ CHRISTINE CARRIERI ” Practice Location

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