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General NPI Number Information
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NPI Number | 1760661763
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Entity Type | Organization
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Legal Business Name | ALICIA RUSSELL CARTER, MD, PC
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 330 W 58TH ST SUITE 501
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City | NEW YORK
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State | NY
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Zip | 10019-1827
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Country | US
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Telephone | 212-265-9803
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Fax |
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Provider Business Mailing Address
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Address Line | 330 W 58TH ST SUITE 501
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City | NEW YORK
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State | NY
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Zip | 10019-1827
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Country | US
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Telephone | 212-265-9803
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Fax |
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Authorized Official
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Title or Position | PRSEIDENT
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Name | DR. ALICIA RUSSELL CARTER
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Credential | M.D.
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Telephone | 212-265-9803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 214129
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License Number State | NY
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