Healthcare Provider Details

I. General information

NPI: 1659472819
Provider Name (Legal Business Name): CAROL KHALARIAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL VARTANIAN

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 LINDEN ST
WELLESLEY MA
02482-7933
US

IV. Provider business mailing address

188 LINDEN ST
WELLESLEY MA
02482-7933
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number240989
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: