Healthcare Provider Details

I. General information

NPI: 1700011392
Provider Name (Legal Business Name): DASHIMA CARTHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 SOUTH AVE FL 3
STATEN ISLAND NY
10314-3404
US

IV. Provider business mailing address

1150 SOUTH AVE FL 3
STATEN ISLAND NY
10314-3404
US

V. Phone/Fax

Practice location:
  • Phone: 718-370-4313
  • Fax:
Mailing address:
  • Phone: 718-370-4313
  • Fax: 718-876-1803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number253716
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: