Provider Demographics
NPI:1457426199
Name:BECKER, CAROLYN BETH (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:BETH
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2201
Mailing Address - Country:US
Mailing Address - Phone:914-232-2021
Mailing Address - Fax:
Practice Address - Street 1:180 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3735
Practice Address - Country:US
Practice Address - Phone:212-305-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173781207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01488751Medicaid
NY08F451Medicare ID - Type Unspecified
NY01488751Medicaid