Dr Stephanie Louise Koontz, MD | |
40 Holland St, Somerville, MA 02144-2705 | |
(617) 629-6330 | |
(617) 629-6128 |
Full Name | Dr Stephanie Louise Koontz |
---|---|
Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 40 Holland St, Somerville, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225108160 | NPI | - | NPPES |
2086115 | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 220863 (Massachusetts) | Primary |
Entity Name | Mt Auburn Professional Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992750996 PECOS PAC ID: 6103725031 Enrollment ID: O20040527001374 |
Mailing Address | Practice Location Address |
---|---|
Dr Stephanie Louise Koontz, MD 40 Holland Street, Somerville, MA 02144 Ph: (617) 629-6330 | Dr Stephanie Louise Koontz, MD 40 Holland St, Somerville, MA 02144-2705 Ph: (617) 629-6330 |
Patricia M Chaudhuri, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 230 Highland Ave, Women's Health Center, Somerville, MA 02143 Phone: 617-591-4800 | |
Sylvia A Fine, Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6000 | |
Fernando Jose Roca Vall-llobera, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6330 | |
Dr. Cari Ellen Brown, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6330 Fax: 617-629-6128 | |
John Kevin Fitzpatrick, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 40 Holland St, Somerville, MA 02144 Phone: 617-629-6330 Fax: 617-629-6128 |