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General NPI Number Information
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NPI Number | 1558328716
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Entity Type | Individual
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Provider Name | CARMEL REID HEINSOHN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 SOUTH ST
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City | BROOKLINE
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State | MA
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Zip | 02467-3658
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Country | US
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Telephone | 617-676-3315
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Fax | 617-469-5013
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Provider Business Mailing Address
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Address Line | 28 BEAVERBROOK RD
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City | NORFOLK
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State | MA
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Zip | 02056-1522
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Country | US
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Telephone | 508-816-6623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 59125
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License Number State | MA
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