Provider Demographics
NPI:1316954035
Name:CARABELLI, MARY (MSN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CARABELLI
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 KUSER RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-581-1878
Mailing Address - Fax:609-581-2632
Practice Address - Street 1:1345 KUSER RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-581-1878
Practice Address - Fax:609-581-2632
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMN35600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
S43745Medicare UPIN
NJ001241NB8Medicare ID - Type Unspecified