Provider Demographics
NPI:1851399125
Name:STONE, KERRY ANNE (MD)
Entity Type:Individual
Prefix:
First Name:KERRY ANNE
Middle Name:
Last Name:STONE
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 1:1 LYONS ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-5599
Mailing Address - Country:US
Mailing Address - Phone:781-493-3620
Mailing Address - Fax:781-461-9210
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-493-3620
Practice Address - Fax:781-461-9210
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214184208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA468785OtherTUFTS BENEFIT ADMINISTRAT
MA63148OtherCHILDREN'S MEDICAL SECURI
MAAA10595OtherHARVARD PILGRIM POS
MA468785OtherTUFTS COMMONWEALTH PPO
MA0032369OtherNEIGHBORHOOD HEALTH PLAN
MA2003155OtherMASS HEALTH(DIV OF MED SV
MA468785OtherTUFTS
MAJ27209OtherBS BLUE CARE ELECT
MA0992521OtherCIGNA HEALTH CARE
MA0992521OtherHEALTHSOURCE
MA468785OtherTUFTS TOTAL HEALTH PLAN
MAAA10595OtherHARVARD PILGRIM PPO
MAJ27209OtherBLUE SHIELD INDEMNITY
MAJ27209OtherHMO BLUE/ BLUE CHOICE
MAAA 10595OtherFIRST SENIORITY
MAAA10595OtherHARVARD PILGRIM
MAAA 10595OtherFIRST SENIORITY
MAAA10595OtherHARVARD PILGRIM PPO