Provider Demographics
NPI:1588214951
Name:CARINO, ROSA M
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:M
Last Name:CARINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:FODERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:232 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2579
Mailing Address - Country:US
Mailing Address - Phone:516-547-4253
Mailing Address - Fax:
Practice Address - Street 1:54 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4422
Practice Address - Country:US
Practice Address - Phone:516-528-6712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor