1801898143 NPI number — ANTHONY M CARISTO DPM

Table of content: ANTHONY M CARISTO DPM (NPI 1801898143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801898143 NPI number — ANTHONY M CARISTO DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARISTO
Provider First Name:
ANTHONY
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1801898143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
774 CHRISTIANA RD
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-623-4250
Provider Business Mailing Address Fax Number:
302-623-4252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
774 CHRISTIANA RD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-2067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-623-4250
Provider Business Practice Location Address Fax Number:
302-623-4252
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  E10000137 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0662838000 . This is a "AMERIHEALTH/KEYSTONE/PC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0001019117 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 226197 . This is a "UNISON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4211789 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: U81205 . This is a "BCBS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 283401 . This is a "MAMSI/OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 105037 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2700489 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7618370 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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