Provider Demographics
NPI:1083904098
Name:CARCAMO, ANDREA REGINA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:REGINA
Last Name:CARCAMO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 HERRONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1901
Mailing Address - Country:US
Mailing Address - Phone:609-497-3300
Mailing Address - Fax:
Practice Address - Street 1:905 HERRONTOWN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1901
Practice Address - Country:US
Practice Address - Phone:609-497-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2016-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 0175592084P0800X
NJ25MB096156002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry