Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 185652 | NY |
NPI | 1114908746 |
---|---|
Provider Name | Francis X Carroll |
First Address | New York, NY 10087-5801 |
Second Address | Carmel, NY 10512-3940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00506318 | (05) | NY |
01573142 | (05) | NY |
A100000178 | MEDICARE PTAN (01) | NY |
F27694 | (02) | NY |
P00639815 | RR MEDICARE (01) | NY |