Healthcare Provider Details
I. General information
NPI: 1982605077
Provider Name (Legal Business Name): CARRIER CLINIC MEDICAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
252 ROUTE 601
BELLE MEAD NJ
08502-3923
US
IV. Provider business mailing address
252 ROUTE 601
BELLE MEAD NJ
08502-3923
US
V. Phone/Fax
- Phone: 908-218-1000
- Fax: 908-281-1676
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: MR.
C
RICHARD
SARLE
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 908-281-1604