Patricia Carpenter
Individual provider Active NPI Specialist · Breezy Point, NY
NPI 1477968600 · NPPES record last updated Jun 26, 2014
Key facts
- NPI
- 1477968600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1389970 (NY)
- Practice address
- 20801 Bayside Walk
Breezy Point, NY 11697-1101 - Phone
- (347) 886-9396
- NPI assigned
- Jun 26, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1389970 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1389970 | NY | Yes |
Addresses
Primary practice location
20801 Bayside Walk
Breezy Point, NY 11697-1101
Mailing address
20801 Bayside Walk
Breezy Point, NY 11697-1101
Phone (347) 886-9396
Other providers in Breezy Point, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.