Basic Information
| Provider Information | |||||||||
| NPI: | 1861561102 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEU | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 LONGFELLOW RD | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021384736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173901401 | ||||||||
| FaxNumber: | 6173901584 | ||||||||
| Practice Location | |||||||||
| Address1: | 49 ROBINWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021302156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173901204 | ||||||||
| FaxNumber: | 6173901584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 35796 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.