Provider Demographics
NPI:1427150838
Name:CARRASCO, RUBEN D (MD PHD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:D
Last Name:CARRASCO
Suffix:
Gender:M
Credentials:MD PHD
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Other - Credentials:
Mailing Address - Street 1:111 CYPRESS STREET
Mailing Address - Street 2:SHEBA SENAT CHARLES BRIGHAMS WOMENS PHYSICIANS ORG
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-713-2239
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:BRIGHAM & WOMENS HOSPITAL DEPT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-525-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA204589207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology