Provider Demographics
NPI:1588986699
Name:CARLA WEISFELD DDS, P.C.
Entity type:Organization
Organization Name:CARLA WEISFELD DDS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:WEISFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-937-3733
Mailing Address - Street 1:18 BRONX ST
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-3302
Mailing Address - Country:US
Mailing Address - Phone:646-546-7036
Mailing Address - Fax:
Practice Address - Street 1:110 WILLETT AVE
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4282
Practice Address - Country:US
Practice Address - Phone:914-937-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053951-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03026377Medicaid