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General NPI Number Information
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NPI Number | 1902397748
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Entity Type | Organization
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Legal Business Name | ANJELICA J CARBAJAL MD LLC
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1 BROOKLINE PL STE 423
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City | BROOKLINE
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State | MA
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Zip | 02445-7237
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Country | US
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Telephone | 617-566-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BROOKLINE PL STE 423
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City | BROOKLINE
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State | MA
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Zip | 02445-7237
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Country | US
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Telephone | 617-566-1535
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANJELICA J CARBAJAL
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Credential | MD
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Telephone | 617-566-1535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 245228
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License Number State | MA
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