Healthcare Provider Details

I. General information

NPI: 1326010877
Provider Name (Legal Business Name): KRISTIN LESLIE RATLIFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 BROCKTON AVE
ABINGTON MA
02351-2186
US

IV. Provider business mailing address

680 CENTRE ST
BROCKTON MA
02302-3308
US

V. Phone/Fax

Practice location:
  • Phone: 781-878-1701
  • Fax: 781-878-4375
Mailing address:
  • Phone: 508-941-7885
  • Fax: 508-941-6337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number218712
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: