=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326265026
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN ROSE HECKMAN MCKAY APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/20/2007
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4513 MANHATTAN COLLEGE PKWY
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10471-4004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-862-7217
-----------------------------------------------------
Fax | 718-862-7797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2643 POST RD
-----------------------------------------------------
City | DARIEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06820-5018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-980-3212
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 002096
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------