Healthcare Provider Details

I. General information

NPI: 1104061498
Provider Name (Legal Business Name): JANET CARNEY DPM,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2008
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 CLAWSON ST
STATEN ISLAND NY
10306-4350
US

IV. Provider business mailing address

923 5TH AVE 12-F
NEW YORK NY
10021-2649
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-9444
  • Fax: 718-979-9422
Mailing address:
  • Phone: 718-979-9444
  • Fax: 718-979-9422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN003855-1
License Number StateNY

VIII. Authorized Official

Name: DR. JANET CARNEY
Title or Position: OWNER
Credential: DPM,PC
Phone: 718-979-1333