Wall Street Physician PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1676231 Issued in NY

Legal business name

WALL STREET PHYSICIAN PLLC

Practice address

111 Broadway
Suite 402
New York, NY 10006-1901

Phone

(212) 784-0072

Fax

(212) 784-0076

NPI assigned

Oct 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cathy A. Carron, M.D.

Title

President

Phone

(212) 784-0072

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1811240112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BROADWAY",
            "address_2": "SUITE 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061901",
            "telephone_number": "212-784-0072",
            "fax_number": "212-784-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BROADWAY",
            "address_2": "SUITE 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061901",
            "telephone_number": "212-784-0072",
            "fax_number": "212-784-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALL STREET PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "CARRON",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-784-0072",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1676231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wall Street Medical PC
• Wall Street Medicine PLLC
• Wall Street Ny Physical Therapy PC
• Wall Street Physical Medicine & Rehabilitation, P.C.
• Wall Street Physical Therapy PC
• Wall Street Podiatry Care PC
• Wall Street Podiatry PC
• Wall Street Psychologists PLLC
• Wall Street Wellness Chiropractic P.C.
• Darryl Wall, LPN

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.