Provider Demographics
NPI:1700867991
Name:ZANGER, KERSTIN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:KERSTIN
Middle Name:
Last Name:ZANGER
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT STREET FND 442
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL NEW BORN SERVICE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-9040
Practice Address - Fax:617-724-9346
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA217600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA217600OtherTUFTS HEALTH PLAN
MA2012472Medicaid
MAJ26340OtherBCBS MA
MA2012472Medicaid
H88291Medicare UPIN