MEDICARE: DASHIMA CARTHEN M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	253716	NY

General Provider Information

NPI Number	:	1700011392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DASHIMA CARTHEN M.D.

Provider Business Mailing Address
First Line	:	1150 SOUTH AVE FL 3
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3404
Country	:	US
Telephone Number	:	718-370-4313
Fax Number	:	718-876-1803

Provider Business Practice Location Address
First Line	:	1150 SOUTH AVE FL 3
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3404
Country	:	US
Telephone Number	:	718-370-4313
Fax Number	:

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

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	07/30/2014

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