MEDICARE: DR. SARACINO GASTROENTEROLGY, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35193	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	2337546	OTHER	NC	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74580	OTHER	NC	BCBS NC GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7237606	OTHER	NC	AETNA/PRONET
5	2414642	OTHER	NC	UNITED HEALTHCARE GROUP

General Provider Information

NPI Number	:	1790752897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SARACINO GASTROENTEROLGY, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 1578
Second Line	:
City	:	KINSTON
State	:	NC
Zip	:	28503-1578
Country	:	US
Telephone Number	:	252-527-6565
Fax Number	:	800-899-1457

Provider Business Practice Location Address
First Line	:	2602 N HERRITAGE ST
Second Line	:
City	:	KINSTON
State	:	NC
Zip	:	28501-1503
Country	:	US
Telephone Number	:	252-527-6565
Fax Number	:	800-899-1457

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JEANA CARTER
Credential	:
Telephone Number	:	252-527-6565

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	12/17/2009

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Directions to “DR. SARACINO GASTROENTEROLGY, P.C. ” Practice Location

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