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General NPI Number Information
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NPI Number | 1093967077
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Entity Type | Organization
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Legal Business Name | SANDRA V. KRISTIANSEN, MD, PC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 176 E MAIN ST SUITE 4
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City | WESTBOROUGH
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State | MA
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Zip | 01581-1763
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Country | US
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Telephone | 508-870-5900
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Fax | 508-870-5960
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Provider Business Mailing Address
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Address Line | 7 REED AVE
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City | WESTBOROUGH
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State | MA
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Zip | 01581-3643
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Country | US
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Telephone | 508-870-5900
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Fax | 508-870-5960
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Authorized Official
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Title or Position | PRESIDENT / PHYSICIAN
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Name | DR. SANDRA V. KRISTIANSEN
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Credential | MD.
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Telephone | 508-870-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 75153
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 75153
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 75153
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License Number State | MA
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