Provider Demographics
NPI:1831223510
Name:VALCARCEL, RAUL
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:VALCARCEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 AVON DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5608
Mailing Address - Country:US
Mailing Address - Phone:609-918-0330
Mailing Address - Fax:609-918-0331
Practice Address - Street 1:685 AVON DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5608
Practice Address - Country:US
Practice Address - Phone:609-918-0330
Practice Address - Fax:609-918-0331
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59139207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
19705OtherUNIVERSITY HEALTH PLAN
P1247975OtherOXFORD
2140022001OtherKEYSTONE
F27538Medicare UPIN
058023Medicare ID - Type Unspecified
19705OtherUNIVERSITY HEALTH PLAN