Provider Demographics
NPI:1063694198
Name:CARMAN, IRENE CZERNIHA (RPH)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:CZERNIHA
Last Name:CARMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 FLOWER AVE W
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3939
Mailing Address - Country:US
Mailing Address - Phone:315-785-9089
Mailing Address - Fax:
Practice Address - Street 1:2308 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1746
Practice Address - Country:US
Practice Address - Phone:888-432-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033736-11835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric