Healthcare Provider Details

I. General information

NPI: 1770230815
Provider Name (Legal Business Name): CAROL EWING GARBER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 WEST 120TH STREET BUILDING 528, ROOM 1058
NEW YORK NY
10027
US

IV. Provider business mailing address

420 RIVERSIDE DR APT 2F
NEW YORK NY
10025-7750
US

V. Phone/Fax

Practice location:
  • Phone: 212-678-3891
  • Fax:
Mailing address:
  • Phone: 401-447-8750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: