Provider Demographics
NPI:1174658017
Name:CARRE, ALEXANDRE JR (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRE
Middle Name:JR
Last Name:CARRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3212
Mailing Address - Country:US
Mailing Address - Phone:860-538-2160
Mailing Address - Fax:860-345-9911
Practice Address - Street 1:267 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3212
Practice Address - Country:US
Practice Address - Phone:860-538-2160
Practice Address - Fax:860-345-9911
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0326112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT260002801Medicare PIN
CT260002148Medicare PIN
F47696Medicare UPIN