Doctor Name: | DAVID CARROLL |
NPI Number: | 1003294802 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 006202 |
Business Practice Address: | 1124 Route 94 Ste 201 New Windsor, NY - 125537258 |
Business Phone Number: | 8454584557 |
Business Fax Number: | 8454584559 |
Mailing Address: | 1124 Route 94 Ste 201, NEW WINDSOR |
State: | NY |
Postal Code: | 125537258 |
Phone Number: | 8454584557 |
Fax Number: | 8454584559 |
NPI Enumeration Date: | 05/12/2015 |
NPI Last Update Date: | 05/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 006202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |