Basic Information
| Provider Information | |||||||||
| NPI: | 1093809386 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ANGELO | ||||||||
| FirstName: | CARRIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 JADE WALK | ||||||||
| Address2: | |||||||||
| City: | MEDFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020522912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085418000 | ||||||||
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| Practice Location | |||||||||
| Address1: | FRANKLIN PEDI. & ADOLES. CARE | ||||||||
| Address2: | 835 W. CENTRAL STREET | ||||||||
| City: | FRANKLIN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085418000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 159257 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.