MEDICARE: KIM K CARAWAY CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	F000580	NY

General Provider Information

NPI Number	:	1437297520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM K CARAWAY CNM

Provider Business Mailing Address
First Line	:	12 MARTIN RD
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-5515
Country	:	US
Telephone Number	:	646-872-0751
Fax Number	:

Provider Business Practice Location Address
First Line	:	534 W 135TH ST
Second Line	:	CHARLES B RANGEL COMMUNITY CENTER -DEPT OB/GYN
City	:	NEW YORK
State	:	NY
Zip	:	10031-8601
Country	:	US
Telephone Number	:	212-491-2300
Fax Number	:	212-491-2323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	10/09/2012

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