Provider Demographics
NPI:1144595117
Name:MUSCETTA, CAROLYN DORA (RN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:DORA
Last Name:MUSCETTA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MYERS CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-2108
Mailing Address - Country:US
Mailing Address - Phone:845-297-0751
Mailing Address - Fax:
Practice Address - Street 1:250 MYERS CORNERS RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-2108
Practice Address - Country:US
Practice Address - Phone:845-297-0751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360687163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator