Provider Demographics
NPI:1912900671
Name:KIRTON, CARL ANTHONY (NP)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:ANTHONY
Last Name:KIRTON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:40 PERSHING RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2632
Mailing Address - Country:US
Mailing Address - Phone:973-773-9572
Mailing Address - Fax:973-773-9572
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-3921
Practice Address - Fax:212-241-4556
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF301588363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health