1972652394 NPI number — DR. SALVATORE JOSEPH CARCARA DMD MS

Table of content: DR. SALVATORE JOSEPH CARCARA DMD MS (NPI 1972652394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972652394 NPI number — DR. SALVATORE JOSEPH CARCARA DMD MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARCARA
Provider First Name:
SALVATORE
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD MS
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:
1972652394
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
381 BROADWAY
Provider Second Line Business Mailing Address:
SUITE 41
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07675
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-664-4443
Provider Business Mailing Address Fax Number:
201-664-9101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
381 BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 41
Provider Business Practice Location Address City Name:
WESTWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-664-4443
Provider Business Practice Location Address Fax Number:
201-664-9101
Provider Enumeration Date:
01/09/2007

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: 1223X0400X , with the licence number:  DI019601 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01527893 . This is a "UNITED CONCORDIA PROVIDER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1010 . This is a "DELTA DENTAL PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 19601 . This is a "DELTA DENTAL PROVIDER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com