Provider Demographics
NPI:1174310809
Name:PAOLETTI, KERRI ANN
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:ANN
Last Name:PAOLETTI
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 1:9 HOWELLS RD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6517
Mailing Address - Country:US
Mailing Address - Phone:631-873-8040
Mailing Address - Fax:
Practice Address - Street 1:12 WATER ST STE 401
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1401
Practice Address - Country:US
Practice Address - Phone:914-435-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673673163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health