Provider Demographics
NPI:1629311675
Name:MANKOWITZ, CARL STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:STEPHEN
Last Name:MANKOWITZ
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 1:302 W 86TH ST
Mailing Address - Street 2:APARTMENT 9B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3141
Mailing Address - Country:US
Mailing Address - Phone:212-496-1537
Mailing Address - Fax:212-721-0896
Practice Address - Street 1:302 W 86TH ST
Practice Address - Street 2:APARTMENT 9B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3141
Practice Address - Country:US
Practice Address - Phone:212-496-1537
Practice Address - Fax:212-721-0896
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine