Healthcare Provider Details

I. General information

NPI: 1043277429
Provider Name (Legal Business Name): CAROLYN A CLINE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BROOKLINE PLACE SUITE 521
BROOKLINE MA
02445-7277
US

IV. Provider business mailing address

ONE BROOKLINE PLACE DRS. JEFFREY KATZ AND CAROLYN CLINE
BROOKLINE MA
02445
US

V. Phone/Fax

Practice location:
  • Phone: 617-735-8800
  • Fax: 617-278-9358
Mailing address:
  • Phone: 617-735-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number74397
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: