Provider Demographics
NPI:1891890232
Name:CARINI, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CARINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:175 MARTIN AVENUE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-9550
Mailing Address - Country:US
Mailing Address - Phone:717-721-5700
Mailing Address - Fax:717-721-5712
Practice Address - Street 1:175 MARTIN AVE
Practice Address - Street 2:SUITE125
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1761
Practice Address - Country:US
Practice Address - Phone:717-721-5700
Practice Address - Fax:717-721-5712
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043855L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA172492OtherTHREE RIVERS
PA662024OtherBLUE SHIELD
PA4292038OtherAETNA
PA50051206OtherCAPITAL BLUE CROSS
PA160048490OtherRRMCR
PA12388180008Medicaid
PA1510648OtherGATEWAY
PA4292038OtherUSH/HMO
PA4292038OtherUSH/HMO
PA1510648OtherGATEWAY