Provider Demographics
NPI:1790823102
Name:KURLANDER, KAREN ALIX (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ALIX
Last Name:KURLANDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4742
Mailing Address - Country:US
Mailing Address - Phone:617-277-5070
Mailing Address - Fax:
Practice Address - Street 1:57A ASPINWALL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-6401
Practice Address - Country:US
Practice Address - Phone:617-277-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03240Medicare ID - Type Unspecified