Provider Demographics
NPI:1083365845
Name:KARDASZEWSKI, CAROLINE NATALIE (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:NATALIE
Last Name:KARDASZEWSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 BADEN PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-6054
Mailing Address - Country:US
Mailing Address - Phone:646-200-1188
Mailing Address - Fax:
Practice Address - Street 1:1360 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1922
Practice Address - Country:US
Practice Address - Phone:718-667-3577
Practice Address - Fax:718-667-3043
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily