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General NPI Number Information
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NPI Number | 1417938192
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Entity Type | Individual
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Provider Name | IRIS WERTHEIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 400 E MAIN ST CAREMOUNT MEDICAL, PC
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3417
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Country | US
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Telephone | 914-241-1050
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Fax | 914-666-2513
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Provider Business Mailing Address
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Address Line | 110 S BEDFORD RD CAREMOUNT MEDICAL, PC
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3446
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Country | US
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Telephone | 914-241-1050
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Fax | 914-666-2513
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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 | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 039006
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 202735-1
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License Number State | NY
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