Provider Demographics
NPI:1225180771
Name:STARR, CAROL W (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:W
Last Name:STARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 RETREAT AVE
Mailing Address - Street 2:SUITE 612
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2528
Mailing Address - Country:US
Mailing Address - Phone:860-524-5911
Mailing Address - Fax:860-247-8182
Practice Address - Street 1:100 RETREAT AVE
Practice Address - Street 2:SUITE 612
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2528
Practice Address - Country:US
Practice Address - Phone:860-524-5911
Practice Address - Fax:860-247-8182
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0329002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001329003Medicaid
CT001329003Medicaid
CTF55904Medicare UPIN