Provider Demographics
NPI:1437286903
Name:TOLMAN, CAROLYN (NP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:TOLMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 STONELEIGH CIR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1330
Mailing Address - Country:US
Mailing Address - Phone:617-926-5770
Mailing Address - Fax:
Practice Address - Street 1:1 HAWTHORNE PL
Practice Address - Street 2:SUITE 105
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2333
Practice Address - Country:US
Practice Address - Phone:617-726-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA164606363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health