Provider Demographics
NPI:1982686010
Name:GIACONA, CARYN M (MD)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:M
Last Name:GIACONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:M
Other - Last Name:BOHRMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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 1:18 LEONARDVILLE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2311
Practice Address - Country:US
Practice Address - Phone:732-671-0860
Practice Address - Fax:732-671-6467
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA6975100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2130993OtherUNITED HEALTHCARE
NJP2537359OtherOXFORD
2653724OtherAETNA HMO
NJ8843708Medicaid
NY47V431OtherEMPIRE BC/BS
5763668OtherAETNA
NJ3719764OtherCIGNA
NY47V432OtherEMPIRE BC/BS
080186451OtherRAILROAD MEDICARE
NJ2K2446OtherHEALTH NET
H24458Medicare UPIN