Provider Demographics
NPI:1033613450
Name:NEGRON, CARLOS A
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:A
Last Name:NEGRON
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 1:214 POND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-1655
Mailing Address - Country:US
Mailing Address - Phone:508-280-4719
Mailing Address - Fax:
Practice Address - Street 1:221 WILLOW ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-1770
Practice Address - Country:US
Practice Address - Phone:508-771-2402
Practice Address - Fax:508-771-2101
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management