Provider Demographics
NPI:1780642926
Name:CARACITAS, ALEXANDRA C (DO)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:C
Last Name:CARACITAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 LAWRIE ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3046
Mailing Address - Country:US
Mailing Address - Phone:732-324-4860
Mailing Address - Fax:732-324-4861
Practice Address - Street 1:516 LAWRIE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3046
Practice Address - Country:US
Practice Address - Phone:732-324-4860
Practice Address - Fax:732-324-4861
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07294100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0003280Medicaid
NJ11069243OtherCAQH ID
NJ07970CBEMedicare ID - Type Unspecified