Tavares, Carolyn Renee
Tavares, Carolyn Renee is an sole proprietor health care provider with primary practice located at 2192 Mecklenburg Rd , Ithaca NY 14850-9322. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Tavares, Carolyn Renee can be contacted via phone (607) 256-3617.Contact Information
Primary practice address
2192 Mecklenburg Rd
Ithaca NY 14850-9322
Phone: (607) 256-3617
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / General Practice | 163WG0000X | 363370-1 | New York |
Profile Details
| NPI number | 1922216258 |
|---|---|
| LBN Legal business name | Tavares, Carolyn Renee |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922216258 | NPPES |
| New York | MEDICAID | 01987508 |
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