Provider Demographics
NPI:1992835581
Name:CARASSO, MONIQUE J (NP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:J
Last Name:CARASSO
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 WEST 33RD STREET
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-356-4765
Mailing Address - Fax:212-356-4949
Practice Address - Street 1:36 7TH AVENUE
Practice Address - Street 2:INFECTIOUS DISEASE HIV AIDS CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-604-1700
Practice Address - Fax:212-356-4949
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2021-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY430021363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0587G1Medicare ID - Type Unspecified
NYQ16062Medicare UPIN