Basic Information
Provider Information
NPI: 1972922870
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARITE
FirstName: JENNIFER
MiddleName: LYNNE
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BLACKMAN
OtherFirstName: JENNIFER
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber:  
FaxNumber: 3026514945
Practice Location
Address1: 1600 ROCKLAND RD STE 2B80
Address2:  
City: WILMINGTON
State: DE
PostalCode: 19803
CountryCode: US
TelephoneNumber: 3026515874
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/08/2014
LastUpdateDate: 08/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207PP0204XMD461601PAN Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
208000000X25MA10160500NJY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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