Provider Demographics
NPI:1326123886
Name:FERMO, CARLOS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:FERMO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3884
Mailing Address - Country:US
Mailing Address - Phone:631-656-8706
Mailing Address - Fax:
Practice Address - Street 1:68 HAUPPAUGE RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4403
Practice Address - Country:US
Practice Address - Phone:631-715-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233776207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine