Provider Demographics
NPI:1457137267
Name:CARNEVALI, MONIQUE (AP, LAC)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:CARNEVALI
Suffix:
Gender:F
Credentials:AP, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 20516
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-1536
Mailing Address - Country:US
Mailing Address - Phone:212-989-3141
Mailing Address - Fax:
Practice Address - Street 1:341 W 24TH ST
Practice Address - Street 2:SUITE 13F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1536
Practice Address - Country:US
Practice Address - Phone:212-989-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4342171100000X
NY003994171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist