Most Relevant Information
Provider Data
| NPI Number: | 1003671942 |
| Provider Name: | CARLA MARIA CAMPOS 252Y00000X |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: | 660027907 |
Most Important Dates
| Enumeration Date: | 02/20/2024 |
| Last Updated: | 02/20/2024 |
Provider Practice Location
124 MAIN ST
GOSHEN
NY
109242133
Practice Location Phone/Fax
| Phone: | 8453606641 |
| Fax: | 8453609076 |
Provider Mailing Location
124 MAIN ST
GOSHEN
NY
109242133
Provider Mailing Phone/Fax
| Phone: | 8453606641 |
| Fax: | 8453609076 |