Provider Demographics
NPI:1508871203
Name:ANZIANI-RULLAN, CARMEN A (MD)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:A
Last Name:ANZIANI-RULLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CALLE JUAN P DUARTE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3513
Mailing Address - Country:US
Mailing Address - Phone:787-753-8527
Mailing Address - Fax:787-753-8527
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:VETERANS ADMINISTRATION CARIBBEAN HEALTHCARE SYSTEM
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR75952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry