Provider Demographics
NPI:1952152308
Name:PARE, CAROL LEE (APN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:LEE
Last Name:PARE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:363 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:PORT MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07758-1359
Practice Address - Country:US
Practice Address - Phone:732-471-0400
Practice Address - Fax:732-471-7949
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19687700363L00000X
NJ26NJ15032200363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner