MEDICARE: CARLA SOFIA MARQUEZ SALAZAR 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942091822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA SOFIA MARQUEZ SALAZAR M.D

Provider Business Mailing Address
First Line	:	25 W 132ND ST APT 16-L
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 EAST 149TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451
Country	:	US
Telephone Number	:	718-579-5030
Fax Number	:

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

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	06/03/2026

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