Provider Demographics
NPI:1295131571
Name:QUATTROCHI, CARRIE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:QUATTROCHI
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 1:436 GATES AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2329
Mailing Address - Country:US
Mailing Address - Phone:516-650-0766
Mailing Address - Fax:516-414-3735
Practice Address - Street 1:436 GATES AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2329
Practice Address - Country:US
Practice Address - Phone:516-650-0766
Practice Address - Fax:516-414-3735
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator