Provider Demographics
NPI:1306040373
Name:CARLOTTI, GINA (MD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CARLOTTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1211 CHESTNUT ST STE 405
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4114
Mailing Address - Country:US
Mailing Address - Phone:215-971-2804
Mailing Address - Fax:215-665-8018
Practice Address - Street 1:1211 CHESTNUT ST STE 405
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4114
Practice Address - Country:US
Practice Address - Phone:215-971-2804
Practice Address - Fax:215-665-8018
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC141045207P00000X, 207Q00000X
NJ25MA08755800207Q00000X
CT54526207Q00000X
PAMD439263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine