Healthcare Provider Details

I. General information

NPI: 1902011232
Provider Name (Legal Business Name): CARL LOPKIN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BEACON ST
BROOKLINE MA
02446-5587
US

IV. Provider business mailing address

1101 BEACON ST
BROOKLINE MA
02446-5587
US

V. Phone/Fax

Practice location:
  • Phone: 617-232-7980
  • Fax:
Mailing address:
  • Phone: 617-232-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CARL LOPKIN
Title or Position: PRESIDENT
Credential: MD
Phone: 617-232-7980