Provider Demographics
NPI:1346268075
Name:EATON, CAROLYN ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ANN
Last Name:EATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:501 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3874
Practice Address - Country:US
Practice Address - Phone:518-393-0391
Practice Address - Fax:518-372-3281
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY223132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY341475OtherMVP
NY7966217OtherAETNA
NY200311OtherSENIOR WHOLE HEALTH
NY36V361OtherEMPIRE BC
NY02193497Medicaid
NY070220000179OtherFIDELIS
NY55550OtherGHI/HMO
NY10058374OtherCDPHP
NY000499348001OtherBSNENY
NY36V361OtherEMPIRE BC
NY070220000179OtherFIDELIS