Healthcare Provider Details

I. General information

NPI: 1205817079
Provider Name (Legal Business Name): CARINE M LENDERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HARRISON AVE # YACC6
BOSTON MA
02118-4001
US

IV. Provider business mailing address

801 ALBANY ST FL GROUND
BOSTON MA
02119-2560
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-4841
  • Fax: 617-414-5741
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number153351
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number153351
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: