Provider Demographics
NPI:1255358271
Name:SAMMARCO, CARRIE L (DRNP)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:SAMMARCO
Suffix:
Gender:F
Credentials:DRNP
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:L
Other - Last Name:SAMMARCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DRNP
Mailing Address - Street 1:240 E 38TH ST
Mailing Address - Street 2:18TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2708
Mailing Address - Country:US
Mailing Address - Phone:646-570-7522
Mailing Address - Fax:646-754-9593
Practice Address - Street 1:240 E 38TH ST
Practice Address - Street 2:18TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2708
Practice Address - Country:US
Practice Address - Phone:646-570-7522
Practice Address - Fax:646-754-9593
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333662363LF0000X
NY33-333662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1255358271OtherNPI