Healthcare Provider Details

I. General information

NPI: 1306222377
Provider Name (Legal Business Name): KARINE GARNEAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HANCOCK ST APT 3
BOSTON MA
02114-4164
US

IV. Provider business mailing address

25 HANCOCK ST APT 3
BOSTON MA
02114-4164
US

V. Phone/Fax

Practice location:
  • Phone: 774-208-4555
  • Fax:
Mailing address:
  • Phone: 774-208-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number263160
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: