Provider Demographics
NPI:1477747541
Name:WESLEY, CARLOS K (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:K
Last Name:WESLEY
Suffix:
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 1:184 E 2ND ST
Mailing Address - Street 2:APT 5G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7745
Mailing Address - Country:US
Mailing Address - Phone:203-500-1611
Mailing Address - Fax:
Practice Address - Street 1:184 E 2ND ST
Practice Address - Street 2:APT 5G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7745
Practice Address - Country:US
Practice Address - Phone:203-500-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTAY1552629-6462207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine