Provider Demographics
NPI:1790752897
Name:DR. SARACINO GASTROENTEROLGY, P.C.
Entity Type:Organization
Organization Name:DR. SARACINO GASTROENTEROLGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-527-6565
Mailing Address - Street 1:PO BOX 1578
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28503-1578
Mailing Address - Country:US
Mailing Address - Phone:252-527-6565
Mailing Address - Fax:800-899-1457
Practice Address - Street 1:2602 N HERRITAGE ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1503
Practice Address - Country:US
Practice Address - Phone:252-527-6565
Practice Address - Fax:800-899-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35193174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC74580OtherBCBS NC GROUP
NC7974580Medicaid
NC7237606OtherAETNA/PRONET
NC2337546OtherMEDICARE PTAN
NC2414642OtherUNITED HEALTHCARE GROUP
NC7237606OtherAETNA/PRONET
NC2414642OtherUNITED HEALTHCARE GROUP