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General NPI Number Information
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NPI Number | 1912017328
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Entity Type | Individual
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Provider Name | MARIA E KANE M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | DIMOCK COMM.HEALTH CENTER 55 DIMOCK STREET
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City | ROXBURY
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State | MA
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Zip | 02119
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Country | US
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Telephone | 617-442-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SALEM RD
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City | WELLESLEY
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State | MA
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Zip | 02481-1254
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Country | US
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Telephone | 617-442-8800
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 31312
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License Number State | MA
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