Provider Demographics
NPI:1619752151
Name:CARMONA, AMY NATALI (MSED)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NATALI
Last Name:CARMONA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14411 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2414
Mailing Address - Country:US
Mailing Address - Phone:718-751-5212
Mailing Address - Fax:
Practice Address - Street 1:1626 PUTNEY RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1818
Practice Address - Country:US
Practice Address - Phone:718-618-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator