Provider Demographics
NPI:1902051261
Name:CARP, RUXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:RUXANDRA
Middle Name:
Last Name:CARP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUXANDRA
Other - Middle Name:
Other - Last Name:ION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 MOUNT VERNON ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2719
Mailing Address - Country:US
Mailing Address - Phone:781-369-5028
Mailing Address - Fax:888-972-1625
Practice Address - Street 1:1 MOUNT VERNON ST
Practice Address - Street 2:SUITE 208
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2719
Practice Address - Country:US
Practice Address - Phone:781-369-5028
Practice Address - Fax:888-972-1625
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-28
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2433672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002721001Medicare PIN