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NPI Code Detail

MEDICARE: DR. CARLOS FERMO JR. MD

MEDICARE: DR. CARLOS FERMO JR. MD
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician233776NY

General Provider Information

NPI Number : 1326123886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS FERMO JR. MD
Provider Business Mailing Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number :
Provider Business Practice Location Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 06/09/2025

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Directions to “ DR. CARLOS FERMO JR. MD” Practice Location

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