Provider Demographics
NPI:1861067175
Name:SCIANDRA, CARLENE FRANCES
Entity type:Individual
Prefix:
First Name:CARLENE
Middle Name:FRANCES
Last Name:SCIANDRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 DELAWARE AVE RM 1200
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-3805
Mailing Address - Country:US
Mailing Address - Phone:716-852-5900
Mailing Address - Fax:716-852-5913
Practice Address - Street 1:69 DELAWARE AVE RM 1200
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-3805
Practice Address - Country:US
Practice Address - Phone:716-852-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY436152-01163WC1500X
NY436152163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health