Provider Demographics
NPI:1568413045
Name:CARRERA, ROSE-MARIE (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:ROSE-MARIE
Middle Name:
Last Name:CARRERA
Suffix:
Gender:F
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 E 13TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2882
Mailing Address - Country:US
Mailing Address - Phone:718-336-4806
Mailing Address - Fax:718-336-4308
Practice Address - Street 1:1833 E 13TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2882
Practice Address - Country:US
Practice Address - Phone:718-336-4806
Practice Address - Fax:718-336-4308
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215539207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02744503Medicaid
NYF40335Medicare UPIN
NY640P91Medicare PIN