Provider Demographics
NPI:1225413123
Name:CARPENZANO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CARPENZANO
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 1:2028 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3539
Mailing Address - Country:US
Mailing Address - Phone:347-223-9832
Mailing Address - Fax:
Practice Address - Street 1:2028 W 10TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3539
Practice Address - Country:US
Practice Address - Phone:347-223-9832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist