Provider Demographics
NPI:1144205923
Name:CARTER, KIMBERLY YUDI (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:YUDI
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:210 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2901
Practice Address - Country:US
Practice Address - Phone:914-681-3100
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23800126207Q00000X
NY223823207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY133884168OtherMULTIPLAN
NY7906913OtherCIGNA
NY133884168OtherBEECH STREET
NY133884168OtherHORIZON HEALTHCAE OF NY
NY223823OtherHIP
NY223823-6I CFPOtherWORKERS COMPENSATION
NY4C8735OtherHEALTH NET
NY5475D1OtherBLUE CROSS
NY7370392OtherAETNA HMO
NY000000086976OtherGHI HMO
NY0899994OtherGHI PPO
NY133884168OtherPHCS
NY2299924OtherUNITED HEALTH CARE
NYP3181688OtherOXFORD
NY133884168OtherPOMCO
NY4C8735OtherHEALTH NET
NY8EZ840/W2L683Medicare ID - Type Unspecified