Healthcare Provider Details

I. General information

NPI: 1700723038
Provider Name (Legal Business Name): PAMELA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 LIVONIA AVE
BROOKLYN NY
11212
US

IV. Provider business mailing address

140 W 139TH ST APT 2A
NEW YORK NY
10030-2292
US

V. Phone/Fax

Practice location:
  • Phone: 551-358-2247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: