Provider Demographics
NPI:1114948759
Name:CARABASI, CHARLES A (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:CARABASI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2157
Mailing Address - Country:US
Mailing Address - Phone:856-983-3373
Mailing Address - Fax:856-983-0959
Practice Address - Street 1:6 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2157
Practice Address - Country:US
Practice Address - Phone:856-983-3373
Practice Address - Fax:856-983-0959
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00387400111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223159415OtherTAX ID
NJ223159415OtherTAX ID
NJ6508034Medicare PIN