Provider Demographics
NPI:1336148196
Name:WHITSETT, CAROL FAY (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:FAY
Last Name:WHITSETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1194
Mailing Address - Street 2:ONE GUSTAVE LEVY PLACE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0313
Mailing Address - Country:US
Mailing Address - Phone:212-241-3985
Mailing Address - Fax:212-534-7491
Practice Address - Street 1:1900 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 500
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1724
Practice Address - Country:US
Practice Address - Phone:516-542-1090
Practice Address - Fax:516-794-8165
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114042207ZB0001X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD31343Medicare UPIN
NY5C3561Medicare ID - Type Unspecified