Provider Demographics
NPI:1912005976
Name:CARPENTIERI, JOSEPH CARMINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CARMINE
Last Name:CARPENTIERI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2 OWENS PL
Mailing Address - Street 2:1
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1743
Mailing Address - Country:US
Mailing Address - Phone:860-658-6366
Mailing Address - Fax:860-658-5300
Practice Address - Street 1:2 OWENS PL
Practice Address - Street 2:1
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-1743
Practice Address - Country:US
Practice Address - Phone:860-658-6366
Practice Address - Fax:860-658-5300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT9567207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD80753Medicare UPIN