Provider Demographics
NPI:1710978481
Name:CARPIO, ORLANDO BUCAG (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:BUCAG
Last Name:CARPIO
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 1:6 ORTON DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-3620
Mailing Address - Country:US
Mailing Address - Phone:718-806-1609
Mailing Address - Fax:718-806-1693
Practice Address - Street 1:611 E 103RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-2501
Practice Address - Country:US
Practice Address - Phone:718-240-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179699207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01157235Medicaid
NY36F541Medicare ID - Type UnspecifiedINDIVIDUAL
NYE89067Medicare UPIN