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Individual

MR. GREGG CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
321 E 34TH ST, NEW YORK, NY 10016-4942
(212) 340-0000
Mailing address
848 RIVER RD, CHATHAM, NJ 07928-1047
(646) 327-7194

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
009854-1
NY

Other

Enumeration date
07/25/2011
Last updated
07/25/2011
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