Provider Demographics
NPI:1689720666
Name:CARY, DAMON D (DO)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:D
Last Name:CARY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 MILTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138
Mailing Address - Country:US
Mailing Address - Phone:215-276-2377
Mailing Address - Fax:
Practice Address - Street 1:1400 PEOPLE PLAZA
Practice Address - Street 2:SUITE 233
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702
Practice Address - Country:US
Practice Address - Phone:302-838-5600
Practice Address - Fax:302-838-5601
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20071032081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEI41183Medicare UPIN
DE492041Medicare ID - Type Unspecified