Provider Demographics
NPI:1619436540
Name:CARRERAS TARTAK, JOSSIE ANTOINETTE (MD)
Entity Type:Individual
Prefix:
First Name:JOSSIE
Middle Name:ANTOINETTE
Last Name:CARRERAS TARTAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOSSIE
Other - Middle Name:ANTOINETTE
Other - Last Name:CARRERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 DEACONESS RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA295600207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine