Organization
UNIVERSAL MEDICAL PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIDIA ROSA CARRERO MD (PRESIDENT)
(718) 672-1100
Entity
Organization
Contact information
Practice address
11034 70TH RD, FOREST HILLS, NY 11375-3934
(718) 672-1100
(718) 672-7770
Mailing address
PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
(631) 264-2035
(631) 264-1418
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
212687
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02103506
—
NY
Enumeration date
01/12/2007
Last updated
05/06/2009
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