Organization
CLR CARTHAGE LLC
Active
Organization
CLR CARTHAGE LLC
Active
Other names
Carthage Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ROZENBERG (MEMBER)
(718) 931-9700
Entity
Organization
Contact information
Practice address
1045 WEST ST, CARTHAGE, NY 13619-9762
(315) 493-3221
(315) 493-6523
Mailing address
4770 WHITE PLAINS RD, BRONX, NY 10470-1104
(718) 931-9700
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00774465
—
NY
Enumeration date
06/05/2017
Last updated
04/27/2018
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