Provider Demographics
NPI:1740718568
Name:CHIARAMONTE, KAYLA MARIE I
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:MARIE
Last Name:CHIARAMONTE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 W END AVE
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1541
Mailing Address - Country:US
Mailing Address - Phone:631-875-1051
Mailing Address - Fax:
Practice Address - Street 1:398 W END AVE
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1541
Practice Address - Country:US
Practice Address - Phone:631-875-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311092164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse