MEDICARE: MR. CARL ANTHONY KIRTON NP

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	363LA2200X	Adult Health Nurse Practitioner	F301588	NY

General Provider Information

NPI Number	:	1912900671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL ANTHONY KIRTON NP

Provider Business Mailing Address
First Line	:	40 PERSHING RD
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07013-2632
Country	:	US
Telephone Number	:	973-773-9572
Fax Number	:	973-773-9572

Provider Business Practice Location Address
First Line	:	1 GUSTAVE L LEVY PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6500
Country	:	US
Telephone Number	:	212-241-3921
Fax Number	:	212-241-4556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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