Provider Demographics
NPI:1407837248
Name:LEMAITRE, KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:LEMAITRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 WARREN STREET
Mailing Address - Street 2:RM 339
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-562-5359
Mailing Address - Fax:617-562-5415
Practice Address - Street 1:134 SOUTH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493
Practice Address - Country:US
Practice Address - Phone:781-893-2224
Practice Address - Fax:781-891-1041
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74808207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3096033Medicaid
MAJ12496Medicare ID - Type Unspecified
MA3096033Medicaid