Provider Demographics
NPI:1124261607
Name:ALCANTARA, CARMELA (MA)
Entity type:Individual
Prefix:MISS
First Name:CARMELA
Middle Name:
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 BATH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3768
Mailing Address - Country:US
Mailing Address - Phone:917-536-2642
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:21 SOUTH 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-3296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program