Healthcare Provider Details

I. General information

NPI: 1497700538
Provider Name (Legal Business Name): KRISTEN CHASE STADTLANDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 LIBBEY PKWY SUITE 301
WEYMOUTH MA
02189-3118
US

IV. Provider business mailing address

163 LIBBEY PKWY SUITE 301
WEYMOUTH MA
02189-3118
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-4224
  • Fax: 781-335-0429
Mailing address:
  • Phone: 781-337-4224
  • Fax: 781-335-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number226535
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number226535
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: