Provider Demographics
NPI:1588024798
Name:MC CARROLL, RAMONA A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:A
Last Name:MC CARROLL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 E LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-1118
Mailing Address - Country:US
Mailing Address - Phone:845-920-8213
Mailing Address - Fax:
Practice Address - Street 1:88 E LEWIS AVE
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-1118
Practice Address - Country:US
Practice Address - Phone:845-920-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY315980-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health