MEDICARE: DR. RALPH ANTHONY CARABASI III M.D.

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	208600000X	Surgery Physician	MD022004E	PA
2	2085R0204X	Vascular & Interventional Radiology Physician	MD022004E	PA
3	2085R0202X	Diagnostic Radiology Physician	MD022004E	PA
4	2086S0129X	Vascular Surgery Physician	MD022004E	PA

General Provider Information

NPI Number	:	1407872070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH ANTHONY CARABASI III M.D.

Provider Business Mailing Address
First Line	:	744 W LANCASTER AVE
Second Line	:	SUITE 225
City	:	WAYNE
State	:	PA
Zip	:	19087-2523
Country	:	US
Telephone Number	:	610-687-5347
Fax Number	:	610-687-1450

Provider Business Practice Location Address
First Line	:	744 W LANCASTER AVE
Second Line	:	SUITE 225
City	:	WAYNE
State	:	PA
Zip	:	19087-2523
Country	:	US
Telephone Number	:	610-687-5347
Fax Number	:	610-687-1450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	09/26/2011

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