1245320936 NPI number — THOMAS F CARRIG MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245320936 NPI number — THOMAS F CARRIG MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CARRIG

Provider First Name:

THOMAS

Provider Middle Name:

F

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1245320936

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/14/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3 COOPER PLZ

Provider Second Line Business Mailing Address:

SUITE 502

Provider Business Mailing Address City Name:

CAMDEN

Provider Business Mailing Address State Name:

NJ

Provider Business Mailing Address Postal Code:

08103-1438

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

856-968-7433

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1 COOPER PLZ

Provider Second Line Business Practice Location Address:

COOPER ANESTHESIA ASSOCIATES

Provider Business Practice Location Address City Name:

CAMDEN

Provider Business Practice Location Address State Name:

NJ

Provider Business Practice Location Address Postal Code:

08103-1461

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

856-968-7433

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/13/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207L00000X , with the licence number:  MA36166 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000581523 . This is a "AMERIHEALTH/PPO/PA BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 010003818 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 050034085 . This is a "RR MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 1081263 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 31443 . This is a "UNIVERISTY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 581523 . This is a "PA BS HIGHMARK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 2320100 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 60001319 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0403224000 . This is a "AMERIHEALTH/KEYSTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0932167 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 2566632 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".