Provider Demographics
NPI:1568497584
Name:CARR, NANCY L (NP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:L
Last Name:CARR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:L
Other - Last Name:SCHLICHTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 EDGEWATER ST
Mailing Address - Street 2:6TH FL. PAYER RELATIONS
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4900
Mailing Address - Country:US
Mailing Address - Phone:718-226-1008
Mailing Address - Fax:718-226-1039
Practice Address - Street 1:450 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3401
Practice Address - Country:US
Practice Address - Phone:718-226-6279
Practice Address - Fax:718-226-8144
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400557363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02268106Medicaid
NY32C15HW681Medicare PIN
NY32C150Z131Medicare PIN