Provider Demographics
NPI:1821384231
Name:CARMENATE, MINEIDA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MINEIDA
Middle Name:
Last Name:CARMENATE
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 1:1224 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4125
Mailing Address - Country:US
Mailing Address - Phone:201-681-2516
Mailing Address - Fax:
Practice Address - Street 1:1224 78TH ST
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4125
Practice Address - Country:US
Practice Address - Phone:201-681-2516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306002-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse