Provider Demographics
NPI:1154078145
Name:DE CAROLIS, BRITTANIE NAUNPAN
Entity Type:Individual
Prefix:
First Name:BRITTANIE
Middle Name:NAUNPAN
Last Name:DE CAROLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 LARCH ST
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4145
Mailing Address - Country:US
Mailing Address - Phone:516-655-0100
Mailing Address - Fax:
Practice Address - Street 1:2219 LARCH ST
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4145
Practice Address - Country:US
Practice Address - Phone:516-655-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist