Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 238030 | MA |
N | 111NI0900X | Internist | 238030 | MA |
N | 207R00000X | Internist | 32505 | DC |
N | 111NI0900X | Internist | 32505 | DC |
Y | 207RH0002X | Hospice and Palliative Medicine | 238030 | MA |
NPI | 1023093747 |
---|---|
Provider Name | Kristen G. Schaefer |
First Address | Boston, MA 02215-5418 |
Second Address | Boston, MA 02215-5418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 20/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H90090 | (02) |