Provider Demographics
NPI:1134255540
Name:CARBAJAL, ANJELICA (MD)
Entity type:Individual
Prefix:
First Name:ANJELICA
Middle Name:
Last Name:CARBAJAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANJELICA
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 BROADWAY
Mailing Address - Street 2:WOMEN'S HEALTH
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-2247
Mailing Address - Country:US
Mailing Address - Phone:617-975-6100
Mailing Address - Fax:617-975-6104
Practice Address - Street 1:1000 BROADWAY
Practice Address - Street 2:WOMEN'S HEALTH
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2247
Practice Address - Country:US
Practice Address - Phone:617-975-6100
Practice Address - Fax:617-975-6104
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245228207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology