Healthcare Provider Details

I. General information

NPI: 1871652644
Provider Name (Legal Business Name): KARI C NADEAU M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FRANCIS ST. SUITE GB
BOSTON MA
02215
US

IV. Provider business mailing address

20 CHAPEL ST A604
BROOKLINE MA
02446
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-7706
  • Fax:
Mailing address:
  • Phone: 650-650-8674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number154115
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: