Provider Demographics
NPI:1104061498
Name:JANET CARNEY DPM,PC
Entity type:Organization
Organization Name:JANET CARNEY DPM,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM,PC
Authorized Official - Phone:718-979-1333
Mailing Address - Street 1:923 5TH AVE
Mailing Address - Street 2:12-F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2649
Mailing Address - Country:US
Mailing Address - Phone:718-979-9444
Mailing Address - Fax:718-979-9422
Practice Address - Street 1:432 CLAWSON ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4350
Practice Address - Country:US
Practice Address - Phone:718-979-9444
Practice Address - Fax:718-979-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003855-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01272540Medicaid
NYT51230Medicare UPIN
NY01272540Medicaid