MEDICARE: ZEV CARROLL MD PC

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	170636	NY

General Provider Information

NPI Number	:	1275620742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEV CARROLL MD PC

Provider Business Mailing Address
First Line	:	1025 CRESTWOOD RD
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1633
Country	:	US
Telephone Number	:	516-569-6828
Fax Number	:	516-569-6828

Provider Business Practice Location Address
First Line	:	14449 70TH AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-1713
Country	:	US
Telephone Number	:	718-353-2975
Fax Number	:	516-569-6828

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ZEV E CARROLL
Credential	:	MD
Telephone Number	:	516-569-6828

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/09/2007

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