Provider Demographics
NPI:1629026265
Name:CARLIN, TERESA MARY (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARY
Last Name:CARLIN
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 1:900 ROUTE 109
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-5259
Mailing Address - Country:US
Mailing Address - Phone:609-884-4357
Mailing Address - Fax:609-884-4377
Practice Address - Street 1:900 ROUTE 109
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-5259
Practice Address - Country:US
Practice Address - Phone:609-884-4357
Practice Address - Fax:609-884-4377
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09249800207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
G30032Medicare UPIN
MDS806826RMedicare ID - Type Unspecified
MDKR51C617Medicare ID - Type Unspecified