Healthcare Provider Details

I. General information

NPI: 1568398022
Provider Name (Legal Business Name): ARCANUM MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 CENTRAL AVE STE 200A
EAST ORANGE NJ
07018-1943
US

IV. Provider business mailing address

576 CENTRAL AVE STE 200A
EAST ORANGE NJ
07018-1943
US

V. Phone/Fax

Practice location:
  • Phone: 917-562-4204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA CARRER
Title or Position: CEO
Credential:
Phone: 917-562-4204