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General NPI Number Information
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NPI Number | 1255441036
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Entity Type | Organization
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Legal Business Name | WEST CARVER MEDICAL ASSOC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 200 WEST CARVER STREET WEST CARVER MEDICAL ASSOC PC
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City | HUNTINGTON
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State | NY
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Zip | 11743
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Country | US
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Telephone | 631-421-0020
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Fax | 631-421-5139
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Provider Business Mailing Address
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Address Line | 200 WEST CARVER STREET WEST CARVER MEDICAL ASSOC PC
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City | HUNTINGTON
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State | NY
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Zip | 11743
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Country | US
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Telephone | 631-421-0020
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Fax | 631-421-5139
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | YVONNE MEYER
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Credential |
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Telephone | 631-421-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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