Individual provider · NPI-1

Anna Carroll, NP

Nurse Practitioner, Gerontology · Islandia, NY

NPI number1255729802
StatusActive
Last updated in NPPESJan 6, 2015

Details

NPI
1255729802
Entity type
Individual (NPI-1)
Name
Anna Carroll
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Jan 6, 2015
Last updated
Jan 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, GerontologyF306998-1NYYes

Practice location

3001 Expressway Dr N
Suite 104
Islandia, NY 11749-5301

Phone 631-435-0110 · Fax 631-435-4582

Mailing address

3001 Expressway Dr N
Suite 104
Islandia, NY 11749-5301

Phone 631-435-0110 · Fax 631-435-4582

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