MEDICARE: CARMY ARISTOR

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922459767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMY ARISTOR

Provider Business Mailing Address
First Line	:	323 BLACKSEED DR # 2
Second Line	:
City	:	GRAYSON
State	:	GA
Zip	:	30017-4305
Country	:	US
Telephone Number	:	347-232-3809
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 E 54TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3344
Country	:	US
Telephone Number	:	800-805-7120
Fax Number	:	678-707-8647

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

Provider Enumeration Date	:	06/22/2016
Last Update Date	:	11/14/2022

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Directions to “ CARMY ARISTOR ” Practice Location

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