Provider Demographics
NPI:1821290123
Name:CAREY, CHARLES J (PA)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:J
Last Name:CAREY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9641
Mailing Address - Country:US
Mailing Address - Phone:267-370-5296
Mailing Address - Fax:215-230-3725
Practice Address - Street 1:4897 YORK ROAD
Practice Address - Street 2:278
Practice Address - City:BUCKINGHAM
Practice Address - State:PA
Practice Address - Zip Code:18912
Practice Address - Country:US
Practice Address - Phone:215-794-7471
Practice Address - Fax:215-794-2576
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00023100363A00000X
PAMA064346363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
051882AAVMedicare PIN
NJS47724Medicare UPIN