Provider Demographics
NPI:1588688394
Name:CARVELLI, ROSEMARIE DELANEY (PCMSN)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:DELANEY
Last Name:CARVELLI
Suffix:
Gender:F
Credentials:PCMSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 OLD DERBY ST STE 451
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4062
Mailing Address - Country:US
Mailing Address - Phone:781-749-5854
Mailing Address - Fax:781-749-5853
Practice Address - Street 1:160 OLD DERBY ST STE 451
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4062
Practice Address - Country:US
Practice Address - Phone:781-749-5854
Practice Address - Fax:781-749-5853
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163548363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANS0436Medicare ID - Type Unspecified