Basic Information
| Provider Information | |||||||||
| NPI: | 1790752897 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. SARACINO GASTROENTEROLGY, P.C. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1578 | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285031578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525276565 | ||||||||
| FaxNumber: | 8008991457 | ||||||||
| Practice Location | |||||||||
| Address1: | 2602 N HERRITAGE ST | ||||||||
| Address2: | |||||||||
| City: | KINSTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285011503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525276565 | ||||||||
| FaxNumber: | 8008991457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2006 | ||||||||
| LastUpdateDate: | 12/17/2009 | ||||||||
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| AuthorizedOfficialLastName: | CARTER | ||||||||
| AuthorizedOfficialFirstName: | JEANA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2525276565 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 35193 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 74580 | 01 | NC | BCBS NC GROUP | OTHER | 7974580 | 05 | NC | MEDICAID | 7237606 | 01 | NC | AETNA/PRONET | OTHER | 2337546 | 01 | NC | MEDICARE PTAN | OTHER | 2414642 | 01 | NC | UNITED HEALTHCARE GROUP | OTHER |