Provider Demographics
NPI:1790850436
Name:JOSEPH L. CARBONE DPM PLLC
Entity Type:Organization
Organization Name:JOSEPH L. CARBONE DPM PLLC
Other - Org Name:ROCHESTER FOOT CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARBONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:585-544-3620
Mailing Address - Street 1:490 TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3541
Mailing Address - Country:US
Mailing Address - Phone:585-544-3620
Mailing Address - Fax:585-544-4567
Practice Address - Street 1:490 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3541
Practice Address - Country:US
Practice Address - Phone:585-544-3620
Practice Address - Fax:585-544-4567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11235CMedicare PIN
NYT26140Medicare UPIN
NY0243590001Medicare NSC
NYT26185Medicare UPIN
NY11235EMedicare PIN
NY11235DMedicare PIN
NY11235AMedicare PIN
NYT26139Medicare UPIN