Provider Demographics
NPI:1992361422
Name:CARMAN, CARL R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:R
Last Name:CARMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 RAHWAY AVE APT J5
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3454
Mailing Address - Country:US
Mailing Address - Phone:609-384-9578
Mailing Address - Fax:
Practice Address - Street 1:16 PEARL ST STE 102
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1962
Practice Address - Country:US
Practice Address - Phone:609-384-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6049103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical