Provider Demographics
NPI:1790177996
Name:DINEROS, CAROLINE REGALA (RN)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:REGALA
Last Name:DINEROS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:CAROLINE
Other - Middle Name:REGALA
Other - Last Name:DINEROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:50 VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1131
Mailing Address - Country:US
Mailing Address - Phone:646-258-7267
Mailing Address - Fax:631-676-4569
Practice Address - Street 1:50 VALLEY AVE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1131
Practice Address - Country:US
Practice Address - Phone:646-258-7267
Practice Address - Fax:631-676-4569
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562997163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health