Provider Demographics
NPI:1124404306
Name:RUXANDRA CARP MD PSYCHIATRY LLC
Entity Type:Organization
Organization Name:RUXANDRA CARP MD PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-369-5029
Mailing Address - Street 1:1 MOUNT VERNON ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2719
Mailing Address - Country:US
Mailing Address - Phone:781-369-5029
Mailing Address - Fax:888-972-1625
Practice Address - Street 1:1 MOUNT VERNON ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2719
Practice Address - Country:US
Practice Address - Phone:781-369-5029
Practice Address - Fax:888-972-1625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2433672084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty