Provider Demographics
NPI:1346261021
Name:CAROSELLA, CHRISTINE ELCIK (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELCIK
Last Name:CAROSELLA
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 1:95 GRASSLANDS RD-NYMC
Mailing Address - Street 2:DEPT OF MEDICINE-MUNGER PAVILION
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-8370
Mailing Address - Fax:914-594-4434
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-681-0926
Practice Address - Fax:914-681-1354
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0530846OtherAETNA HMO
WP787OtherOXFORD
4C7239OtherHEALTHNET
992203OtherMVP
CC6813OtherATLANTIS
110108414OtherRAILROAD MEDICARE
NY5957132OtherAETNA PPO
NY2505721OtherGHI PPO
NY746982OtherBCBS OF NY WHITE PLAINS
NY01619525Medicaid
NY00000025694OtherGHI HMO
NY746982OtherBCBS OF NY WHITE PLAINS