Provider Demographics
NPI:1861782971
Name:CARPENTER, CHRISTINA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:161 FORT WASHINGTON AVE FL 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-305-9918
Mailing Address - Fax:212-342-1065
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-9918
Practice Address - Fax:212-342-1065
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2929552088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05183468Medicaid