Provider Demographics
NPI:1477549368
Name:POLEY, KAREN JEAN (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:POLEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:77 WARREN ST
Mailing Address - Street 2:RM 339
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:617-562-5359
Mailing Address - Fax:617-562-5415
Practice Address - Street 1:11 NEVINS ST.
Practice Address - Street 2:STE 407
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-783-0095
Practice Address - Fax:617-783-4460
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA156685207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3181553Medicaid
MAA28388Medicare ID - Type Unspecified
MA3181553Medicaid