Provider Demographics
NPI:1124228648
Name:CARINO VASCULAR SURGERY MD PC
Entity Type:Organization
Organization Name:CARINO VASCULAR SURGERY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-753-0913
Mailing Address - Street 1:1037 RT. 46 EAST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2461
Mailing Address - Country:US
Mailing Address - Phone:856-753-0913
Mailing Address - Fax:856-753-4490
Practice Address - Street 1:1037 RT. 46 EAST
Practice Address - Street 2:SUITE 103
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2461
Practice Address - Country:US
Practice Address - Phone:856-753-0913
Practice Address - Fax:856-753-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03260800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56474Medicare UPIN