Provider Demographics
NPI:1982263315
Name:CARVINO, NICOLE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:CARVINO
Suffix:
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 1:1 PHEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838-2431
Mailing Address - Country:US
Mailing Address - Phone:908-528-7212
Mailing Address - Fax:
Practice Address - Street 1:1 PHEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:GREAT MEADOWS
Practice Address - State:NJ
Practice Address - Zip Code:07838-2431
Practice Address - Country:US
Practice Address - Phone:908-528-7212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer