Provider Demographics
NPI:1275966269
Name:CARLASCIO INC
Entity Type:Organization
Organization Name:CARLASCIO INC
Other - Org Name:CARLASCIO ORTHOPEDIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLASCIO
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED ORTHOTIST
Authorized Official - Phone:201-333-8716
Mailing Address - Street 1:1094 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2384
Mailing Address - Country:US
Mailing Address - Phone:973-340-6500
Mailing Address - Fax:973-778-3838
Practice Address - Street 1:1094 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2384
Practice Address - Country:US
Practice Address - Phone:973-340-6500
Practice Address - Fax:973-778-3838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARLASCIO INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7419708Medicaid