Organization
IMELDA A. CARIN, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMELDA A. CARIN M.D. (PRESIDENT)
(973) 299-1168
Entity
Organization
Contact information
Practice address
302 BROADWAY, BROOKLYN, NY 11211-7308
(718) 384-0010
(718) 599-4632
Mailing address
40 RIVER DR, LAKE HIAWATHA, NJ 07034-2807
(973) 229-1168
(973) 299-1355
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
149173-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00715182
—
NY
01
—
245246
HMO WELLCARE
NY
01
—
60518589A
HMO FIDELIS CARE
NY
Enumeration date
09/05/2007
Last updated
03/07/2023
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