Von Tiesenhausen, Katja
Von Tiesenhausen, Katja is an individual health care provider with primary practice located at 10 Gove St , East Boston MA 02128-1920. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Von Tiesenhausen, Katja can be contacted via phone (617) 569-5800.Contact Information
Primary practice address
10 Gove St
East Boston MA 02128-1920
Phone: (617) 569-5800
Fax: (617) 568-4780
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 216177 | Massachusetts |
Profile Details
| NPI number | 1902870793 |
|---|---|
| LBN Legal business name | Von Tiesenhausen, Katja |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 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 | 1902870793 | NPPES |
| Massachusetts | MEDICAID | 2008904 |
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