Healthcare Provider Details

I. General information

NPI: 1225106545
Provider Name (Legal Business Name): CARLO S ASARO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

27 RUGGIERO WAY
BUDD LAKE NJ
07828-2471
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-6107
  • Fax: 718-918-6509
Mailing address:
  • Phone: 718-344-9524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005322
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: