Provider Demographics
NPI:1174138598
Name:CARIAS, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CARIAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 JOHNSTON AVE APT 568
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-4330
Mailing Address - Country:US
Mailing Address - Phone:732-791-8027
Mailing Address - Fax:
Practice Address - Street 1:18 PARK VIEW AVE APT 314
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-7381
Practice Address - Country:US
Practice Address - Phone:732-791-8027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20000306112255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer