Provider Demographics
NPI:1437160660
Name:CAROLINA GYNECOLOGY PA
Entity type:Organization
Organization Name:CAROLINA GYNECOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TORSONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-846-6962
Mailing Address - Street 1:700 EXPOSITION PL
Mailing Address - Street 2:STE 161
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-1560
Mailing Address - Country:US
Mailing Address - Phone:919-846-6962
Mailing Address - Fax:
Practice Address - Street 1:700 EXPOSITION PL
Practice Address - Street 2:STE 161
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1560
Practice Address - Country:US
Practice Address - Phone:919-846-6962
Practice Address - Fax:919-841-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100797261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH37619Medicare UPIN