Carlson, Ilene E
Carlson, Ilene E is an individual health care provider with primary practice located at 680 Centre St Pathology Department, Brockton MA 02302-3308. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Carlson, Ilene E can be contacted via phone (508) 941-7414.Contact Information
Primary practice address
680 Centre St Pathology Department
Brockton MA 02302-3308
Phone: (508) 941-7414
Fax: (508) 941-6295
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 153189 | Massachusetts |
Profile Details
| NPI number | 1457395097 |
|---|---|
| LBN Legal business name | Carlson, Ilene E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457395097 | NPPES |
| Massachusetts | MEDICAID | 3167119 |
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