MEDICARE: EUGENE C. CARROCCIA, M.D.,P.A.

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	208200000X	Plastic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

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

Provider Business Mailing Address
First Line	:	8512 VENTNOR AVE
Second Line	:
City	:	MARGATE CITY
State	:	NJ
Zip	:	08402-2500
Country	:	US
Telephone Number	:	609-822-8200
Fax Number	:	609-822-8287

Provider Business Practice Location Address
First Line	:	8512 VENTNOR AVE
Second Line	:
City	:	MARGATE CITY
State	:	NJ
Zip	:	08402-2500
Country	:	US
Telephone Number	:	609-822-8200
Fax Number	:	609-822-8287

Authorized Official
Title or Position	:	OWNER
Name	:	DR. EUGENE C. CARROCCIA
Credential	:	M.D.
Telephone Number	:	609-822-8200

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	08/24/2015

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