Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 004876-1 | NY |
NPI | 1487978771 |
---|---|
Provider Name | Michael Carthen |
First Address | Brooklyn, NY 11234-2441 |
Second Address | Brooklyn, NY 11234-2441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2010 |
Last Update Date | 16/03/2010 |