Healthcare Provider Details

I. General information

NPI: 1518950906
Provider Name (Legal Business Name): CAROL HARRACKSINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 VETERANS RD STE 111
YORKTOWN HEIGHTS NY
10598-4130
US

IV. Provider business mailing address

200 VETERANS RD STE 11
YORKTOWN HEIGHTS NY
10598-4187
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-3056
  • Fax: 914-962-9046
Mailing address:
  • Phone: 914-245-3056
  • Fax: 914-962-9046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1845441
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: