Healthcare Provider Details

I. General information

NPI: 1407366735
Provider Name (Legal Business Name): DONYA LASHAWN CARTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2017
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

22 CORNERS RD
CONGERS NY
10920-1222
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5000
  • Fax:
Mailing address:
  • Phone: 646-523-8004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number342305
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number632533
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: