Provider Demographics
NPI:1588855928
Name:CAMARGO FAYE, ERICA CRISTINA SA DE (MD, MSC, PHD)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:CRISTINA SA DE
Last Name:CAMARGO FAYE
Suffix:
Gender:F
Credentials:MD, MSC, PHD
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:CRISTINA SA DE
Other - Last Name:CAMARGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MSC, PHD
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:WACC 733
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-8459
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WACC 733
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2472462084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology