Provider Demographics
NPI:1194802843
Name:STEPHEN S CARRYL, MD, PC
Entity type:Organization
Organization Name:STEPHEN S CARRYL, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARRYL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-783-0934
Mailing Address - Street 1:PO BOX 7247-7912
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19170-7912
Mailing Address - Country:US
Mailing Address - Phone:718-250-8944
Mailing Address - Fax:718-250-8060
Practice Address - Street 1:ONE HANSON PLACE
Practice Address - Street 2:SUITE 710
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11243
Practice Address - Country:US
Practice Address - Phone:718-783-0934
Practice Address - Fax:718-857-0162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191367208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty