Provider Demographics
NPI:1720066467
Name:CAROLAN, STEPHEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:F
Last Name:CAROLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 THEALL RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1404
Mailing Address - Country:US
Mailing Address - Phone:914-848-8800
Mailing Address - Fax:914-848-8801
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8800
Practice Address - Fax:914-848-8801
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028686207V00000X, 207VF0040X
NY174162-1207V00000X
NY174162207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01074822Medicaid
NY174162-1OtherWORKERS COMPENSATION
NYC07742Medicare UPIN
NY01074822Medicaid
NY28E761Medicare PIN
NY0546154OtherCIGNA
NY133884168OtherBEECH STREET
NY133884168OtherMULTIPLAN
NYWP298OtherOXFORD
NY1189117OtherUNITED HEALTH CARE
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY174162-1OtherWORKERS COMPENSATION
NY4252104OtherAETNA NON HMO
NY133884168OtherPHCS
NY28E761Medicare PIN
NY726924OtherCONNECTICARE
NY133884168OtherHORIZON HEALTHCARE OF NY
NY3745912OtherAETNA HMO
NY3C7512OtherHEALTH NET
NYC07742Medicare UPIN