| Doctor Name: | DR. JEFFREY A CARMEN |
| NPI Number: | 1265427512 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH. D. |
| License Number: | 5908 |
| Business Practice Address: | 4016 Henneberry Rd Manlius, NY - 131048532 |
| Business Phone Number: | 3156825272 |
| Business Fax Number: | 3156824716 |
| Mailing Address: | 4016 Henneberry Rd, MANLIUS |
| State: | NY |
| Postal Code: | 131048532 |
| Phone Number: | 3156825272 |
| Fax Number: | 3156824716 |
| NPI Enumeration Date: | 09/13/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 5908 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |