Provider Demographics
NPI:1043267735
Name:REDNOR, KAREN ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELLEN
Last Name:REDNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:162 CORDAVILLE RD STE 185
Mailing Address - Street 2:PO BOX 296
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1838
Mailing Address - Country:US
Mailing Address - Phone:508-229-8811
Mailing Address - Fax:508-229-0666
Practice Address - Street 1:162 CORDAVILLE RD
Practice Address - Street 2:SUITE 185
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1838
Practice Address - Country:US
Practice Address - Phone:508-229-8811
Practice Address - Fax:508-229-0666
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA72055208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110047970AMedicaid