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General NPI Number Information
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NPI Number | 1023392354
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Entity Type | Organization
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Legal Business Name | WESLEY V. CARRION, MD PC
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 1 SHORE DR
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City | SETAUKET
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State | NY
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Zip | 11733-1619
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Country | US
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Telephone | 631-751-3117
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Fax | 631-751-8560
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Provider Business Mailing Address
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Address Line | 1 SHORE DR
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City | SETAUKET
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State | NY
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Zip | 11733-1619
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Country | US
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Telephone | 631-751-3117
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Fax | 631-751-8560
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WESLEY VANWYE CARRION
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Credential | M.D.
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Telephone | 631-751-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 1932276
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License Number State | NY
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