Provider Demographics
NPI:1972596393
Name:COMUNIELLO, CARL JEFFEREY (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JEFFEREY
Last Name:COMUNIELLO
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:967 N BROADWAY
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIA
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1301
Mailing Address - Country:US
Mailing Address - Phone:914-964-4972
Mailing Address - Fax:914-964-4433
Practice Address - Street 1:967 N BROADWAY
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1301
Practice Address - Country:US
Practice Address - Phone:914-964-4972
Practice Address - Fax:914-964-4433
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY203644-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1566494Medicaid
NY1975786Medicaid
NY1975786Medicaid
NYG97597Medicare UPIN
NY31B741Medicare ID - Type Unspecified