Individual
CARL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3733 RICHMOND AVE, STATEN ISLAND, NY 10312-3827
(718) 743-7090
Mailing address
3733 RICHMOND AVE, STATEN ISLAND, NY 10312-3827
(718) 967-5300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
185799
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01251789
—
NY
Enumeration date
06/01/2006
Last updated
06/04/2008
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