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General NPI Number Information
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NPI Number | 1174962773
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Entity Type | Individual
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Provider Name | DANIELLE CARCIA D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 832 BRUNSWICK AVE
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City | TRENTON
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State | NJ
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Zip | 08638-3847
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Country | US
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Telephone | 609-815-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 23203 COLUMBUS RD STE 1
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City | COLUMBUS
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State | NJ
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Zip | 08022-1984
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT015028
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS017285
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB10106600
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License Number State | NJ
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