Provider Demographics
NPI:1841342482
Name:CARNEY, BLANCHE MARJORIE (NP)
Entity type:Individual
Prefix:MS
First Name:BLANCHE
Middle Name:MARJORIE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 E END AVE
Mailing Address - Street 2:6F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7928
Mailing Address - Country:US
Mailing Address - Phone:212-249-3761
Mailing Address - Fax:
Practice Address - Street 1:145 W 84TH ST
Practice Address - Street 2:ROOM 115
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4614
Practice Address - Country:US
Practice Address - Phone:917-441-5656
Practice Address - Fax:917-441-5787
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380154-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics