Provider Demographics
NPI:1750561668
Name:ISRAEL, CAROLYN TRUPTI (MCAT, DTR)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:TRUPTI
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:MCAT, DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HIGH ST APT 204
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2655
Mailing Address - Country:US
Mailing Address - Phone:831-459-8421
Mailing Address - Fax:831-459-8421
Practice Address - Street 1:131 FRONT ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4401
Practice Address - Country:US
Practice Address - Phone:831-459-8421
Practice Address - Fax:831-459-8421
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist