Individual
MRS. CARLIN BORDEN VICKERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1125 5TH AVE, NEW YORK, NY 10128-0143
(212) 288-9800
(212) 860-7446
Mailing address
1255 5TH AVE, NEW YORK, NY 10029-3852
(212) 996-9500
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
144463
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N27472
HEALTH NET
NY
01
—
P621719
OXFORD
NY
Enumeration date
08/30/2006
Last updated
07/08/2007
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