Healthcare Provider Details

I. General information

NPI: 1790774834
Provider Name (Legal Business Name): JOANNE BORG STEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 WALNUT ST SPAULDING NEWTON WELLESLEY REHAB CENTER
WELLESLEY MA
02481-2118
US

IV. Provider business mailing address

PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
CHARLESTOWN MA
02129-9142
US

V. Phone/Fax

Practice location:
  • Phone: 781-431-9144
  • Fax: 781-431-9152
Mailing address:
  • Phone: 781-431-9144
  • Fax: 781-431-9152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number75662
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: