Provider Demographics
NPI:1285949735
Name:CARRAL, JOAQUIN (MD)
Entity type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:CARRAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOAQUIN
Other - Middle Name:
Other - Last Name:CARRAL GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:102 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3275
Mailing Address - Country:US
Mailing Address - Phone:413-325-8500
Mailing Address - Fax:
Practice Address - Street 1:102 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3275
Practice Address - Country:US
Practice Address - Phone:413-325-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53592207R00000X
NH20246207R00000X
MA1014956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine