Basic Information
Provider Information
NPI: 1285274977
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PYLE
FirstName: CAROLINE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 FEDERAL ST # 200
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081031088
CountryCode: US
TelephoneNumber: 8563564924
FaxNumber:  
Practice Location
Address1: 2 COOPER PLZ
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081031461
CountryCode: US
TelephoneNumber: 8556322667
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/09/2020
LastUpdateDate: 05/20/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/20/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X26NJ01007000NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
163W00000X26NR1586200NJN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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