Provider Demographics
NPI:1518508522
Name:CARLOS REMOLINA MD PA
Entity Type:Organization
Organization Name:CARLOS REMOLINA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGUILIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-356-0990
Mailing Address - Street 1:812 N WOOD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4058
Mailing Address - Country:US
Mailing Address - Phone:908-241-2030
Mailing Address - Fax:908-241-5692
Practice Address - Street 1:812 N WOOD AVE STE 301
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4058
Practice Address - Country:US
Practice Address - Phone:908-241-2030
Practice Address - Fax:908-241-5692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3046605Medicaid