Basic Information
| Provider Information | |||||||||
| NPI: | 1841285335 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KILLIAN | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661254 | ||||||||
| FaxNumber: | 9146661931 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661254 | ||||||||
| FaxNumber: | 9146661931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 05/02/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 206671 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4147735 | 01 | NY | MVP PIN# | OTHER | 3404691 | 01 | AETNA HMO PIN # | OTHER | 02041770 | 05 | NY | MEDICAID | 1006727 | 01 | CDPHP PIN # | OTHER | 5C4633 | 01 | NY | HEALTHNET | OTHER | 26C671 | 01 | NY | EMPIRE BC BS | OTHER | 7171238 | 01 | NY | AETNA PPO | OTHER | 2101172 | 01 | UNITED HC | OTHER | 061009000087 | 01 | NY | FIDELIS CARE PIN # | OTHER | 000000106125 | 01 | NY | GHI HMO PIN # | OTHER | 4799172 | 01 | NY | GHI PPO | OTHER | P1974833 | 01 | OXFORD PIN # | OTHER |