Provider Demographics
NPI:1871589432
Name:CARPENTIER, PAUL ARMAND (MD, CFCMC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ARMAND
Last Name:CARPENTIER
Suffix:
Gender:M
Credentials:MD, CFCMC
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MONTAUK HWY
Mailing Address - Street 2:MATERNAL FETAL MEDICINE DEPT
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4927
Mailing Address - Country:US
Mailing Address - Phone:631-376-3232
Mailing Address - Fax:631-376-4245
Practice Address - Street 1:1000 MONTAUK HWY
Practice Address - Street 2:MATERNAL FETAL MEDICINE DEPT
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4927
Practice Address - Country:US
Practice Address - Phone:631-376-3232
Practice Address - Fax:631-376-4245
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2016-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58409207Q00000X
NY282655207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3044513Medicaid
MASX1988OtherMEDICARE PTAN
MA3044513Medicaid
MAJ08068Medicare PIN