MEDICARE: DR. KRISTIN M. PERINI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	157878	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	157878	OTHER	MA	TUFTS HEALTH PLAN
2	710817	OTHER	MA	HARVARD PILGRIM
3	J22191	OTHER	MA	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912982257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIN M. PERINI MD

Provider Business Mailing Address
First Line	:	56 NEW DRIFTWAY
Second Line	:
City	:	SCITUATE
State	:	MA
Zip	:	02066-4533
Country	:	US
Telephone Number	:	781-545-7243
Fax Number	:	781-210-2854

Provider Business Practice Location Address
First Line	:	56 NEW DRIFTWAY
Second Line	:
City	:	SCITUATE
State	:	MA
Zip	:	02066-4533
Country	:	US
Telephone Number	:	781-545-7243
Fax Number	:	781-210-2854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	05/16/2008

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