Provider Demographics
NPI:1235494469
Name:CAGNINA, CARLA
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:CAGNINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2414
Mailing Address - Country:US
Mailing Address - Phone:609-927-0203
Mailing Address - Fax:609-927-0217
Practice Address - Street 1:519 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2414
Practice Address - Country:US
Practice Address - Phone:609-927-0203
Practice Address - Fax:609-927-0217
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0097700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health