Provider Demographics
NPI:1013657337
Name:CARLIN, CARLY ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:ALEXANDRA
Last Name:CARLIN
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 1:85 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6950
Mailing Address - Country:US
Mailing Address - Phone:914-420-7631
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER
Practice Address - Street 2:ONE MEDICAL CENTER PLACE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program