Provider Demographics
NPI:1346235322
Name:CARLO, JOCELYN A (MD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:A
Last Name:CARLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3530
Mailing Address - Country:US
Mailing Address - Phone:732-974-8404
Mailing Address - Fax:732-974-8904
Practice Address - Street 1:1924 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3530
Practice Address - Country:US
Practice Address - Phone:732-974-8404
Practice Address - Fax:732-974-8904
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07868900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI35622Medicare UPIN
NJ092988NJ9Medicare PIN