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General NPI Number Information
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NPI Number | 1124267372
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Entity Type | Individual
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Provider Name | MAURICE CARR CERTIFICATE
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Gender | Male
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 1727 AMSTERDAM AVE
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City | NEW YORK
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State | NY
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Zip | 10031-4611
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Country | US
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Telephone | 212-694-9200
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Fax | 212-694-9230
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Provider Business Mailing Address
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Address Line | 2761 UNIVERSITY AVE
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City | BRONX
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State | NY
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Zip | 10468-2616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 9978465
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License Number State |
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