Provider Demographics
NPI:1437297520
Name:CARAWAY, KIM K (CNM)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:K
Last Name:CARAWAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5515
Mailing Address - Country:US
Mailing Address - Phone:646-872-0751
Mailing Address - Fax:
Practice Address - Street 1:534 W 135TH ST
Practice Address - Street 2:CHARLES B RANGEL COMMUNITY CENTER -DEPT OB/GYN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-8601
Practice Address - Country:US
Practice Address - Phone:212-491-2300
Practice Address - Fax:212-491-2323
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000580363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology