Healthcare Provider Details

I. General information

NPI: 1033299136
Provider Name (Legal Business Name): PAULINE B REOHR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY CLINIC 41 MALL RD.
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

7300 RANCH ROAD 2222, BUILDING 1, STE 200
AUSTIN TX
78730
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8457
  • Fax: 781-744-5687
Mailing address:
  • Phone: 512-628-0465
  • Fax: 512-233-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number80664
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: