Provider Demographics
NPI:1124478177
Name:WINIK, CAROLYN PAIGE (MS EDUCATION)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:PAIGE
Last Name:WINIK
Suffix:
Gender:F
Credentials:MS EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 28TH AVE
Mailing Address - Street 2:APT 22
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2153
Mailing Address - Country:US
Mailing Address - Phone:917-881-9791
Mailing Address - Fax:
Practice Address - Street 1:4308 28TH AVE
Practice Address - Street 2:APT 22
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-2153
Practice Address - Country:US
Practice Address - Phone:917-881-9791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1031226161174400000X
NY1031266161174400000X
NY990064151174400000X
NY990060151174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist