Provider Demographics
NPI:1700965183
Name:CARRINGTON, CARMELITA VERONICA (LPN)
Entity Type:Individual
Prefix:MS
First Name:CARMELITA
Middle Name:VERONICA
Last Name:CARRINGTON
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 1:301 ARNETT BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1125
Mailing Address - Country:US
Mailing Address - Phone:585-764-1515
Mailing Address - Fax:585-464-0583
Practice Address - Street 1:301 ARNETT BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1125
Practice Address - Country:US
Practice Address - Phone:585-764-1515
Practice Address - Fax:585-464-0583
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227496-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02150347Medicaid