Provider Demographics
NPI:1588483622
Name:MUSCARELLO, KAILEE ROSE (RN)
Entity type:Individual
Prefix:
First Name:KAILEE
Middle Name:ROSE
Last Name:MUSCARELLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-2224
Mailing Address - Country:US
Mailing Address - Phone:631-339-2431
Mailing Address - Fax:
Practice Address - Street 1:410 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1404
Practice Address - Country:US
Practice Address - Phone:631-793-8624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY949429163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health