Provider Demographics
NPI:1841285335
Name:KILLIAN, CAROL ANN (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:KILLIAN
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 1:400 E MAIN ST
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-666-1254
Mailing Address - Fax:914-666-1931
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-1254
Practice Address - Fax:914-666-1931
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY206671207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4147735OtherMVP PIN#
3404691OtherAETNA HMO PIN #
NY02041770Medicaid
1006727OtherCDPHP PIN #
NY5C4633OtherHEALTHNET
NY26C671OtherEMPIRE BC BS
NY7171238OtherAETNA PPO
2101172OtherUNITED HC
NY061009000087OtherFIDELIS CARE PIN #
NY000000106125OtherGHI HMO PIN #
NY4799172OtherGHI PPO
P1974833OtherOXFORD PIN #
2101172OtherUNITED HC