Provider Demographics
NPI:1376174102
Name:CARLEY, YOLANDA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:CARLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BRONSON RD
Mailing Address - Street 2:
Mailing Address - City:POUGHQUAG
Mailing Address - State:NY
Mailing Address - Zip Code:12570-5000
Mailing Address - Country:US
Mailing Address - Phone:914-755-7494
Mailing Address - Fax:646-588-0282
Practice Address - Street 1:115 E STEVENS AVE STE 1
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1270
Practice Address - Country:US
Practice Address - Phone:914-552-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY489573-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY489573-1OtherRN REGISTRATION CERTIFICATE
NY489573-1OtherREGISTERED NURSE