Provider Demographics
NPI:1528457926
Name:CARATAO-MOJICA, RHEA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:
Last Name:CARATAO-MOJICA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9819 64TH AVE
Mailing Address - Street 2:APT. 1A
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2309 31ST ST
Practice Address - Street 2:STE 3
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2767
Practice Address - Country:US
Practice Address - Phone:718-204-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306792-1363LA2200X
NYF340930-1364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology