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Organization
WALL STREET PHYSICIAN PLLC
Active
Organization
WALL STREET PHYSICIAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY A. CARRON M.D. (PRESIDENT)
(212) 784-0072
Entity
Organization
Contact information
Practice address
111 BROADWAY, SUITE 402, NEW YORK, NY 10006-1901
(212) 784-0072
(212) 784-0076
Mailing address
111 BROADWAY, SUITE 402, NEW YORK, NY 10006-1901
(212) 784-0072
(212) 784-0076
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1676231
NY
Other
Enumeration date
10/24/2012
Last updated
08/15/2014
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