Provider Demographics
NPI:1740373646
Name:CARUANA, JOAN (RN NP)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:CARUANA
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 WEST 12TH STREET
Mailing Address - Street 2:6D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1927
Mailing Address - Country:US
Mailing Address - Phone:212-645-5793
Mailing Address - Fax:
Practice Address - Street 1:80 8TH AVE
Practice Address - Street 2:STE 709
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5126
Practice Address - Country:US
Practice Address - Phone:212-645-5793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF4002851363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
98V751Medicare UPIN