Wanukovich, Carla Marie

Wanukovich, Carla Marie is an sole proprietor health care provider with primary practice located at 29 Puritan Ave , East Patchogue NY 11772-5516. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Wanukovich, Carla Marie can be contacted via phone (631) 626-0964.

Contact Information

Primary practice address
29 Puritan Ave East Patchogue NY 11772-5516
Fax: (631) 569-4761
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1552615 New York

Profile Details

NPI number 1972866408
LBN Legal business name Wanukovich, Carla Marie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2012
Last updated Jun 19th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972866408 NPPES
New York Other 174400000X SPECIALIST

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