Provider Demographics
NPI:1699840132
Name:STEIN, ARIANNA PATRICIA (CNM)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:PATRICIA
Last Name:STEIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ARIANNA
Other - Middle Name:PATRICIA
Other - Last Name:HERZER STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:62 PITCHER AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2101
Mailing Address - Country:US
Mailing Address - Phone:617-510-7817
Mailing Address - Fax:781-749-2133
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1699
Practice Address - Country:US
Practice Address - Phone:617-243-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242841367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ23003Medicare UPIN