Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 25MA06319600 | NJ |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | NJMA63196 | NJ |
NPI | 1275639783 |
---|---|
Provider Name | Ricardo Caraballo |
First Address | Boston, MA 02241-6457 |
Second Address | Voorhees, NJ 08043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0094687000 | AMERIHEALTH/KEYSTONE/IBC (01) | NJ |
010003742 | AMERICHOICE (01) | NJ |
1105869 | HORIZON NJ HEALTH (01) | NJ |
1949172 | UNITED HEALTHCARE (01) | NJ |
2207042/7597015 | AETNA (01) | NJ |
24212 | UNIVERSITY HEALTH PLAN (01) | NJ |
3K7732 | HEALTHNET (01) | NJ |
7780702 | (05) | NJ |
9402184 | CIGNA (01) | NJ |
G86002 | (02) | |
P2704813 | OXFORD (01) | NJ |