Provider Demographics
NPI:1497707194
Name:MORABITO, CARRIE L (AUD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:MORABITO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:L
Other - Last Name:ADAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:1100 LONG POND RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1154
Mailing Address - Country:US
Mailing Address - Phone:585-225-1100
Mailing Address - Fax:585-225-1112
Practice Address - Street 1:1100 LONG POND RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1154
Practice Address - Country:US
Practice Address - Phone:585-225-1100
Practice Address - Fax:585-225-1112
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001935-1174400000X
NY14000018507174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0007528631OtherAETNA
NYP00249342OtherRAILROAD MEDICARE PIN
NY7102000NY14626OtherBC/BS OF MICHIGAN
NY050564171OtherUNITED HEALTH CARE
NY142140AIOtherPREFERRED CARE
NYP010001935OtherEXCELLUS
NY050564171OtherSCREEN ACTORS GUILD
NY0007528631OtherAETNA
NY050564171OtherAHAC TIN
NY7102000NY14626OtherBC/BS OF MICHIGAN