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NPI Code Detail

MEDICARE: DR. LARRY CARTER D.O.

MEDICARE: DR. LARRY CARTER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician25MB06744300NJ

General Provider Information

NPI Number : 1164421491
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY CARTER D.O.
Provider Business Mailing Address
First Line : 192 GREGORY AVE
Second Line :
City : WEST ORANGE
State : NJ
Zip : 07052-4530
Country : US
Telephone Number : 973-243-1951
Fax Number :
Provider Business Practice Location Address
First Line : 1 BAY AVE
Second Line :
City : MONTCLAIR
State : NJ
Zip : 07042-4837
Country : US
Telephone Number : 973-429-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY CARTER D.O.” Practice Location

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