Provider Demographics
NPI:1609942499
Name:PACIS, CARLO P
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:P
Last Name:PACIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 WELL SWEEP RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3250
Mailing Address - Country:US
Mailing Address - Phone:908-534-9847
Mailing Address - Fax:
Practice Address - Street 1:18 E 50TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-9109
Practice Address - Country:US
Practice Address - Phone:646-436-2966
Practice Address - Fax:212-421-9299
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0446081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice