Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 028686 | CT |
Y | 207V00000X | Obstetrician & Gynecologist | 174162-1 | NY |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 028686 | CT |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 174162 | NY |
NPI | 1720066467 |
---|---|
Provider Name | Stephen F Carolan |
First Address | Rye, NY 10580-1404 |
Second Address | Rye, NY 10580-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 04/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01074822 | (05) | NY |
174162-1 | WORKERS COMPENSATION (01) | NY |
C07742 | (02) | NY |