Provider Demographics
NPI:1891838363
Name:HANSON, KATHARINE B (MD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:B
Last Name:HANSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1105 MASSACHUSETTS AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5220
Mailing Address - Country:US
Mailing Address - Phone:617-492-9766
Mailing Address - Fax:
Practice Address - Street 1:1105 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5220
Practice Address - Country:US
Practice Address - Phone:617-492-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA724052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry