Provider Demographics
NPI:1194109215
Name:ROUND, CAROLINE (FNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:ROUND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 E 102ND ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5204
Mailing Address - Country:US
Mailing Address - Phone:212-659-8551
Mailing Address - Fax:212-831-8116
Practice Address - Street 1:17 E 102ND ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5204
Practice Address - Country:US
Practice Address - Phone:212-659-8551
Practice Address - Fax:212-831-8116
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339887-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331058Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NY331943Medicare Oscar/Certification