Provider Demographics
NPI:1538982970
Name:CARCHI, JERRY
Entity type:Individual
Prefix:
First Name:JERRY
Middle Name:
Last Name:CARCHI
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 1:135 BROOKSIDE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1584
Mailing Address - Country:US
Mailing Address - Phone:201-697-8437
Mailing Address - Fax:
Practice Address - Street 1:135 BROOKSIDE AVE APT 2
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1584
Practice Address - Country:US
Practice Address - Phone:201-697-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach