Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00329300 | NJ |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NR11590900 | NJ |
NPI | 1518252238 |
---|---|
Provider Name | Crystal Carlino |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2011 |
Last Update Date | 17/01/2018 |