Provider Demographics
NPI:1548603020
Name:CARBONE, DAVID JOSEPH (BOCO, CPED)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:CARBONE
Suffix:
Gender:M
Credentials:BOCO, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1275 DELAWARE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2412
Mailing Address - Country:US
Mailing Address - Phone:716-881-0499
Mailing Address - Fax:716-884-1128
Practice Address - Street 1:1275 DELAWARE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2412
Practice Address - Country:US
Practice Address - Phone:716-881-0499
Practice Address - Fax:716-884-1128
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYBOC C51119222Z00000X
NYCPED 1546224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist