Provider Demographics
NPI:1639138654
Name:CARO, SIXTO R
Entity Type:Individual
Prefix:DR
First Name:SIXTO
Middle Name:R
Last Name:CARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 IRVING PL
Mailing Address - Street 2:1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2208
Mailing Address - Country:US
Mailing Address - Phone:718-599-0505
Mailing Address - Fax:718-599-6859
Practice Address - Street 1:231 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-5601
Practice Address - Country:US
Practice Address - Phone:718-599-0505
Practice Address - Fax:718-599-6859
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00325764Medicaid
NYC09031Medicare UPIN
NY351231Medicare PIN
NYC09031Medicare UPIN