Provider Demographics
NPI:1295189397
Name:CARMEL MEDICAL CARE P.C.
Entity Type:Organization
Organization Name:CARMEL MEDICAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-228-7000
Mailing Address - Street 1:1511 ROUTE 22
Mailing Address - Street 2:SUITE 197
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509
Mailing Address - Country:US
Mailing Address - Phone:845-228-7000
Mailing Address - Fax:845-228-5485
Practice Address - Street 1:91 GLENEIDA AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1222
Practice Address - Country:US
Practice Address - Phone:845-228-7000
Practice Address - Fax:845-228-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY234086208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty