Provider Demographics
NPI:1083909774
Name:LINDGREN, KRISTEN A (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 OAK ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1453
Mailing Address - Country:US
Mailing Address - Phone:617-762-1540
Mailing Address - Fax:617-412-3064
Practice Address - Street 1:193 OAK ST STE 1
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1453
Practice Address - Country:US
Practice Address - Phone:617-762-1540
Practice Address - Fax:617-412-3064
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2671012084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty