MEDICARE: CARYNE JEAN MICHEL CM

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	174N00000X	Lactation Consultant (Non-RN)	L-30454	NY
2	176B00000X	Midwife	001971	NY
3	367A00000X	Advanced Practice Midwife	001971	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659846889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARYNE JEAN MICHEL CM

Provider Business Mailing Address
First Line	:	1847 SHORE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-6619
Country	:	US
Telephone Number	:	347-546-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1847 SHORE PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-6619
Country	:	US
Telephone Number	:	347-546-0360
Fax Number	:

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

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	05/27/2025

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