Healthcare Provider Details

I. General information

NPI: 1679896542
Provider Name (Legal Business Name): EUGENE C. CARROCCIA, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8512 VENTNOR AVE
MARGATE CITY NJ
08402-2500
US

IV. Provider business mailing address

8512 VENTNOR AVE
MARGATE CITY NJ
08402-2500
US

V. Phone/Fax

Practice location:
  • Phone: 609-822-8200
  • Fax: 609-822-8287
Mailing address:
  • Phone: 609-822-8200
  • Fax: 609-822-8287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENE C. CARROCCIA
Title or Position: OWNER
Credential: M.D.
Phone: 609-822-8200