Provider Demographics
NPI:1689693996
Name:CARERI, JOHN A (MSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:CARERI
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:A
Other - Last Name:CARERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:3130 BIRCH PL
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3805
Mailing Address - Country:US
Mailing Address - Phone:516-503-7426
Mailing Address - Fax:516-781-5155
Practice Address - Street 1:6080 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2850
Practice Address - Country:US
Practice Address - Phone:516-503-7426
Practice Address - Fax:516-781-5155
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0163171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN07932Medicare ID - Type Unspecified