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Ms. Carla Marie Wanukovich
Specialist in East Patchogue, New York
NPI 1972866408

Carla Marie Wanukovich is a Specialist based in East Patchogue, NY. Carla Marie Wanukovich practices in East Patchogue, NY. The NPI Number for Carla Marie Wanukovich is 1972866408 and holds a License No. 1552615 (New York).

The current practice location address for Carla Marie Wanukovich is 29 Puritan Ave, East Patchogue, NY and can be reached out via phone at 631-626-0964 and via fax at 631-569-4761.

Location: 29 Puritan Ave, East Patchogue, NY, 11772-5516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972866408
Provider Name
Carla Marie Wanukovich
Credential
Provider Entity Type
Individual
Gender
Female
Address
29 Puritan Ave, East Patchogue, NY, 11772-5516
Phone Number
631-626-0964
Fax Number
631-569-4761
Provider Enumeration Date
06/19/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
174400000X 01 NY SPECIALIST
institution
Provider Business Practice Location Address Details
Address
29 Puritan Ave
City
East Patchogue
State
New York
Zip
11772-5516
Phone Number
631-626-0964
Fax Number
631-569-4761
person
Provider Business Mailing Address Details
Address
29 Puritan Ave
City
East Patchogue
State
New York
Zip
11772-5516
Phone Number
631-626-0964
Fax Number
631-569-4761
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1552615 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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