Provider Demographics
NPI:1770807992
Name:FAMILIA, CARMEN YBELICE (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:YBELICE
Last Name:FAMILIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:YBELICE
Other - Last Name:AUERBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:629 WEST 185TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3102
Mailing Address - Country:US
Mailing Address - Phone:212-928-3900
Mailing Address - Fax:212-795-0470
Practice Address - Street 1:1276 FULTON AVE FL 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-3402
Practice Address - Country:US
Practice Address - Phone:718-901-8297
Practice Address - Fax:718-901-8589
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program